| NPI | 1487416962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE RICHARDSON Member/Organizer 336-687-9826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-03-29 |