| NPI | 1932589587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDNEY JAMES MILTZ Owner 252-202-1848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 3419) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 952) |
| 101YP2500X Counselor, Professional (Licence: NC 8762) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2017-01-24 |