| NPI | 1346979093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRESSA CORBETT Administrator 336-541-3485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 175T00000X Peer Specialist | |
| 207Q00000X Family Medicine | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207QA0505X Family Medicine, Adult Medicine | |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2022-10-10 |