| NPI | 1326563925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN WIDENHOUSE JENKINS Owner/Practitioner 252-327-3239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 10305) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 10305) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3250) | |
| 101YP2500X Counselor, Professional (Licence: NC 10305) | |
| 225C00000X Rehabilitation Counselor (Licence: NC 10305) | |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X (Licence: NC 3250) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC 10305) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NC 10305) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NC 3250) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2021-01-12 |