| NPI | 1508488917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN LLOYD PERRY Owner 704-908-4061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |