| NPI | 1134421043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY EDWIN JACKSON Clinical Director 910-297-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: NC 8702255) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2010-11-29 |