| NPI | 1205415932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN GRAHAM Owner 910-241-9108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2022-06-16 |