| NPI | 1023366325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE RICHARDS Owner 336-965-5922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251E00000X Home Health |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2012-08-17 |