| NPI | 1134587157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LEE SANDER Sole/Managing Member 336-404-9286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC PC10773) |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-04 |