| NPI | 1457866105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL D LAWSON Administrator 919-988-6620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A11401) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3391-A) |
| 1041C0700X Social Worker, Clinical (Licence: NC C008406) | |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2017-12-04 |