| NPI | 1336955848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN MICHELLE KELLER Owner 336-396-9239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-15 |