| NPI | 1053595546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICETINE P ROUSE Administrator 252-522-4869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC MHL054111) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2008-07-21 |