| NPI | 1013163344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE MYLES MCCLAIN Executive Director 910-273-3278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NC 305S00000X) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |