| NPI | 1942289244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY PETTEWAY Credentialing Specialist 252-439-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC 0003507) |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-05-10 |