| NPI | 1730849373 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LAKEISHA ROGERS Owner 336-534-5172  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-12-22 | 
| Last Update Date | 2021-12-22 |