| 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 |