| NPI | 1407109820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASAUNDRA DENISE MOODY CEO 980-239-4383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |