| NPI | 1326289943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN WILSON CEO 910-678-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NC 34418) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 34418) |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2009-03-11 |