| NPI | 1790219871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL NDUPU Clinical Director 980-224-8060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 4936) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2019-09-06 |