| NPI | 1285921064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS FAULKNER Member Manager 336-392-1606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C003085) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-07-21 |