| NPI | 1821732256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINCY JOHNSON Owner 910-644-0108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2022-10-21 |