| NPI | 1386254662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN JEFFORDS BONSALL Therapist 336-661-5053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-08-03 |