| NPI | 1154615805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY WHITE DAVIS Co Owner 336-883-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2011-05-30 |
| Last Update Date | 2011-05-30 |