| NPI | 1427848373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANAAY LIVINGSTON Owner/Office Administrative 336-978-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |