| NPI | 1699283663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY WICKER Owner 919-774-1131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2039) |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-09-06 |