| NPI | 1518101906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELTON WADE DE VOSE Executive Clinical Director 919-381-5703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 4985) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC C006249) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC 2001-00146) | |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2010-04-05 |