| NPI | 1760728125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS ROMAN COO 910-628-9091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2012-12-12 |