| NPI | 1104071687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WILLIAM BODFISH Director 919-966-4896 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: NC 1466) |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2008-11-25 |