| NPI | 1194124412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY DEAN POWELL Director 910-309-1574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 3565) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2014-08-22 |