| NPI | 1861069080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELLE KORNEGAY CEO 919-294-9621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2022-10-17 |