| NPI | 1053887075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA VAUGHAN Owner 336-688-6217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |