| NPI | 1518349000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SMITH Clinical Director 910-769-6053 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2022-04-21 |