| NPI | 1134253875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETITHIA PELHAM PARKER Director 336-505-0384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: NC MHL04177) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |