| NPI | 1932154408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA L DANIEL Office Manager 336-629-7112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 0078) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-08-22 |