| NPI | 1568094225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA COLEMON Chief Executive Officer 980-745-9867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 171M00000X Case Manager/Care Coordinator | |
| 225C00000X Rehabilitation Counselor | |
| 251S00000X | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-08-03 |