| NPI | 1760784573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY JACKSON Executive Director 910-238-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 28713) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 28713) |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2010-11-30 |