| NPI | 1275769200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEKA DAVIS SHAW Executive Director/Owner 910-797-5661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 7255) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 7255) |
| 103T00000X Psychologist (Licence: NC 1596) | |
| 251S00000X Community/Behavioral Health (Licence: NC 7255) | |
| 252Y00000X Early Intervention Provider Agency (Licence: NC 7255) | |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2010-12-07 |