NPI | 1851438956 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES LUTHER BURSTON Director Owner 336-613-5515 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C001740) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 325) |
103T00000X Psychologist (Licence: NC 170) | |
Enumeration Date | 2007-01-30 |
Last Update Date | 2025-09-11 |