| NPI | 1336624543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN C BORCYK Co Owner 336-345-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2018-10-03 |