| NPI | 1578333845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN WILSON Qualified Professional 336-420-3796 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 251B00000X Case Management | |
| 101YM0800X Counselor Mental Health | |
| 251S00000X Community/Behavioral Health | |
| 261QH0100X Clinic/Center Health Service | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |