| NPI | 1801628334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA'COURTNEY SETZER COO 828-244-2622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-08-15 |