| NPI | 1841411071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRIA DIXON CFO 252-258-8946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 200100499) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 200100499) |
| 101YM0800X Counselor Mental Health (Licence: NC 200100499) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2011-12-15 |