| NPI | 1619728573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA CHEVELLE WADDELL Owner 336-954-7345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2025-11-18 |