| NPI | 1114175635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN DIANE PERRY Program Director 252-243-7174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: NC MHL098050) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2008-09-09 |