| NPI | 1275168775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYSIA ALLEN Co Owner/ Clinical Operations 336-580-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2022-07-11 |