| NPI | 1679297618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALILAH Z SLADE Practice Owner 919-454-5383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-24 |