| NPI | 1952668501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWANA TORRENCE Owner 336-471-8130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2012-04-20 |