| NPI | 1902511660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY LASHAWN GOSS Owner/Mental Health Clinician 919-895-1255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2023-01-17 |