| 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 | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-11-26 |
| Last Update Date | 2023-12-05 |