| NPI | 1205348661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK REGISTER CEO 336-443-6703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C004968) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1723) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2021-12-03 |