| NPI | 1700559366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC EVERETTE Owner 919-709-1518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2021-12-09 |