| NPI | 1053449157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS TREVOUR SHEPARD Manager 910-938-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: NC MHL067-069) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NC MHL067-069) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |