| NPI | 1568712990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABBY WASHINGTON Billing & Finance Mgr 336-716-5583 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2024-05-22 |