| NPI | 1417741018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANGILA JENALL JOHNSON CEO 910-751-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-04-08 |