| NPI | 1114204856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEDRIC WILKINS Owner 252-793-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2011-11-09 |