| NPI | 1518242221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MICKLE President 919-488-7139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2011-10-13 |