| NPI | 1265673651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIA VANEUS Owner 336-279-1227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 8302770) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 8302770) | |
| 101YM0800X Counselor, Mental Health (Licence: NC 8302770) | |
| 101YP2500X Counselor, Professional (Licence: NC 8302770) | |
| 103K00000X Behavior Analyst (Licence: NC 8302770) | |
| 104100000X Social Worker (Licence: NC 8302770) | |
| 1041C0700X Social Worker, Clinical (Licence: NC 8302770) | |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2021-10-07 |