| NPI | 1962703777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUETTA HARRISON BULLOCK Executive Directr 252-430-1681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP1600X Counselor, Pastoral | |
| 1041C0700X Social Worker, Clinical | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2011-03-31 |