| NPI | 1891399184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARSHIA DONNELL Manager 336-823-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP1600X Counselor Pastoral | |
| 1041C0700X Social Worker Clinical | |
| 261Q00000X Clinic/Center | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-11-26 |
| Last Update Date | 2023-12-05 |