| NPI | 1124185657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD P EDWARDS Contract Administrator 919-783-8898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2015-11-20 |