| NPI | 1962699629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE FITZGERALD Executive Director 910-891-7062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC MHL-053-053) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2007-10-09 |