| NPI | 1578269155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA M SLOANE Director 336-455-3139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-06 |