| NPI | 1295445716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYETTA LOVELEE COOPER Owner 910-212-7634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 1041C0700X Social Worker, Clinical | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 261QP2300X Clinic/Center, Primary Care | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 251B00000X Case Management | |
| 101YM0800X Counselor, Mental Health | |
| 385H00000X Respite Care | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2025-10-23 |