| NPI | 1104130632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA S PARKER Clinical Director 919-896-4380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2010-07-26 |