| NPI | 1003285164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA COUCH Owner 919-530-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC LCAS-21691) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |