| NPI | 1053676908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIOUS ERNEST HAILEY Executive Director 336-628-4636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-076-110) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2016-03-08 |