| NPI | 1528586997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY PRINCESS MCCOY Executive D Irector 336-804-1325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 104100000X Social Worker | |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2017-09-06 |