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Organization

MYRIAD SUPPORT CENTER

Active
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Organization

MYRIAD SUPPORT CENTER

Active
Parent organization
SURRENT CAPITAL, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SURRENT CAPITAL, INC
Authorized official
MR. YUSSEF LATEEF GILKEY (CEO)
(336) 575-2002
Entity
Organization

Contact information

Practice address
3540 VEST MILL RD STE 6, WINSTON SALEM, NC 27103-2988
(336) 602-2940
Mailing address
3540 VEST MILL RD STE 6, WINSTON SALEM, NC 27103-2988

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—

Other

Enumeration date
07/09/2010
Last updated
07/09/2010
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