| NPI | 1356069264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLITA RANDALL Executive Director 980-276-5142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YS0200X Counselor School | |
| 251B00000X Case Management | |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2023-01-05 |