| NPI | 1902910623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED FITZGERALD Executive Director 910-891-7062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC mhl-062-020) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC MHL-062-020) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2009-01-15 |