| NPI | 1316825383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINCY WIGGINS Owner 252-217-8119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-08-26 |
| Last Update Date | 2025-08-26 |