| NPI | 1356114169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN COCKERHAM Owner 336-977-5686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |