| NPI | 1801671573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN ERVIN Executive Director / Founder 336-971-1719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2024-04-09 |