NPI | 1104005735 |
---|---|
Entity Type | Organization |
Authorized Contact | OLIVER FORD Owner/President 910-381-0125 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL 067-167) |
Enumeration Date | 2007-10-31 |
Last Update Date | 2009-09-14 |