| NPI | 1982921227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY SCOTT PHILLIPS Clinical Director 980-284-1639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| 103T00000X Psychologist | |
| 133V00000X Dietitian, Registered | |
| 163W00000X Registered Nurse | |
| 175T00000X Peer Specialist | |
| 225100000X Physical Therapist | |
| 225800000X Recreation Therapist | |
| 225C00000X Rehabilitation Counselor | |
| 225X00000X Occupational Therapist | |
| 251B00000X Case Management | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2022-07-11 |