| NPI | 1386424141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN GREGORY BAGSHAW Owner 336-909-0192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2023-10-04 |