| NPI | 1164071262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA JOHNSON Chief Executive Officer 336-860-1514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251E00000X Home Health | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-19 |