| NPI | 1528563194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASIE HALL Owner 252-430-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 11825) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-21329) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-03-27 |