| NPI | 1912309907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRINA WINFORD Ower 336-896-9771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 341372) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 341372) |
| 101YP2500X Counselor Professional (Licence: NC 341372) | |
| 251B00000X Case Management (Licence: NC 341372) | |
| 253Z00000X In Home Supportive Care (Licence: NC 341372) | |
| 302F00000X Exclusive Provider Organization (Licence: NC 341372) | |
| 302R00000X Health Maintenance Organization (Licence: NC 341372) | |
| 305R00000X Preferred Provider Organization (Licence: NC 341372) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC 341372) | |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2014-09-22 |