| NPI | 1770716730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELLIE NEWSOM Executive Director 252-410-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261Q00000X Clinic/Center | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2011-08-10 |