| NPI | 1669925681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHUKAIRO TOWNSEND President 980-474-7757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC CP-11094) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC L0215) |
| 1041C0700X Social Worker, Clinical (Licence: NC C008389) | |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-07-26 |