| NPI | 1245502798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA FULLER Executive Director 980-300-7889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 106H00000X Marriage & Family Therapist | |
| 106H00000X Marriage & Family Therapist | |
| 171M00000X Case Manager/Care Coordinator | |
| 225XM0800X Occupational Therapist, Mental Health | |
| 302R00000X Health Maintenance Organization | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2025-03-19 |