| NPI | 1780338509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ANTHONY BURCHETTE Managing Member 336-423-6140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2024-08-01 |