| NPI | 1336661826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUEVELYN JACOBS TILLMAN Owner 910-336-3554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P009630) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: NC 21969) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2019-04-27 |