| NPI | 1386824852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAD DAVIS Owner/Director 910-739-1445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-11-13 |