| NPI | 1861039729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELDA SIMMONS Executive Director 980-999-5006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 251B00000X Case Management | |
| 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health | |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2019-12-10 |