| NPI | 1154798338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVAN JULIUS FOSTER Owner 919-394-5104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-096-258) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |