| NPI | 1124457718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUPERT MCCORMAC Chief Executive Officer 800-805-6989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NC MHL-011-298) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM2800X Clinic/Center Methadone (Licence: NC MHL-011-298) | |
| 261QP2300X Clinic/Center Primary Care | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2024-09-03 |