| NPI | 1902100019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY WALSTER GRAHAM COO 910-640-1038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 251B00000X Case Management | |
| 251C00000X | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2011-01-25 |