| NPI | 1831220862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED FITZGERALD Executive Director 910-891-7062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: mhl-004-014) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2009-01-14 |