| NPI | 1760172555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLAN M FAIRCLOTH CEO 919-630-5144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-05-15 |