| NPI | 1508671256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB BRADLEY LONG CEO 336-553-8147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-02-16 |