| NPI | 1003049685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH A BAGLEY Organizer 336-721-4261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC C2009212000082) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2009-08-28 |