| NPI | 1790388775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA FOSTER Owner/Manager 910-703-4640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2024-01-22 |