| NPI | 1407240047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVETTA BOLDIN CEO/Owner 919-904-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 9700466) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 9700466) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 9700466) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NC 9700466) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NC 9700466) | |
| 251B00000X Case Management (Licence: NC 9700466) | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X Community/Behavioral Health (Licence: NC 9700466) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: NC 9700466) | |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-03-20 |