| NPI | 1790062057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA ELIZABETH KIDD Member/Manager 910-339-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2014-10-03 |