| NPI | 1518309558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS A NELSON Vice President 336-685-1185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2013-07-18 |