| NPI | 1235685405 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LATASHA MICHELLE BETHEA Owner 910-853-2184 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101YP2500X Counselor, Professional | 
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2016-08-28 | 
| Last Update Date | 2016-08-28 |