| NPI | 1396262085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY LEONARD Manager/Therapist 910-489-0429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 9092) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2305) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2022-07-11 |