| NPI | 1972790632 |
|---|---|
| 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) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC MHL-053-053) |
| 101YM0800X Counselor Mental Health (Licence: NC MHL-053-053) | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2007-10-09 |