| NPI | 1093905119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY LEE SHEPHERD Owner 910-686-8667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC HC3479) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2007-09-19 |