| NPI | 1346039898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTRAVON HERBIN Agency Director 336-491-9906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-05-01 |