| NPI | 1740762160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA H TUCKER CEO 336-210-8409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QP2300X Clinic/Center, Primary Care | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2018-09-01 |
| Last Update Date | 2025-08-04 |