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 (Licence: NC MHL-011-298) |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
261QM2800X Clinic/Center, Methadone Clinic (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 |