| NPI | 1124267265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALNA TEEL Provider 910-592-7451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL082056) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |