| NPI | 1588942403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA CASSANDRA KELLY Owner 910-261-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical (Licence: NC C006537) | |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |