| NPI | 1508021080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN LONG Executive Director 336-322-0657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2019-06-04 |