| NPI | 1336710979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROCK M GRACE Owner & Managing Member 336-624-7866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101Y00000X Counselor | |
| 104100000X Social Worker | |
| 261Q00000X Clinic/Center | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2023-02-22 |