| NPI | 1588161350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTINA BROADNAX CEO 980-365-9879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |