| NPI | 1083166227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMECA D RICKS Owner 252-557-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C009720) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2016-11-03 |