| NPI | 1194119131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA M CANO-JOHNSON Director 980-621-8401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C009256) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2022-05-01 |