| NPI | 1730979436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH PARK Lcsw 919-430-1047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-07 |
| Last Update Date | 2025-05-07 |