| NPI | 1528829041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMASHA HARRELL Adminstrator/ Owner 252-287-3168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |