| NPI | 1801402045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANASIA ROSS Owner 910-714-8638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QA0600X Clinic/Center Adult Day Care | |
| 261QC1500X Clinic/Center Community Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |