| NPI | 1770861023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA ROYSTER Owner 888-870-4935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 8105) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1748) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2011-08-03 |