NPI | 1871522003 |
---|---|
Entity Type | Organization |
Authorized Contact | TARSHIA DONNELL Regional Director 336-301-4264 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 9700286) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
1041C0700X Social Worker, Clinical | |
261QM1300X Clinic/Center, Multi-Specialty | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2006-07-01 |
Last Update Date | 2023-12-07 |