| NPI | 1013773936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN MILLER Owner 910-338-9093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |