| NPI | 1952531188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS ROMAN COO 910-770-2682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2011-09-23 |