| NPI | 1629821681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MARIE JIMENEZ Owner 336-612-1827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-04-22 |