| NPI | 1881482099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA Z LONG Owner 336-964-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-04-28 |