| NPI | 1538853635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARA NATAKA ADESIMBO GRIMES Owner 336-840-9609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 175T00000X Peer Specialist | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-08-19 |