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