| NPI | 1053745992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE KAREN KELLY CEO 910-292-2518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC MHL043091) |
| Additional Taxonomies | 251S00000X (Licence: MHL043091) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2014-09-24 |