| NPI | 1497235626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REZELL GORE CEO/ Clinical Supervisor 910-287-5430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C010441) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20470) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |