| NPI | 1245316173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN LUCINDA LEE Office Manager 910-221-5269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 243) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 5199) |
| 103T00000X Psychologist (Licence: NC 1347) | |
| 103T00000X Psychologist (Licence: NC 3183) | |
| 1041C0700X Social Worker Clinical (Licence: NC 1738) | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NC 36397) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |