| NPI | 1720871767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOTHEL WATSON President 336-470-8149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 175T00000X Peer Specialist | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2025-05-23 |
| Last Update Date | 2025-06-04 |