| NPI | 1417135500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN COAXUM CEO 910-483-0324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 222Q00000X Developmental Therapist | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-026-857) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2022-05-20 |