| NPI | 1164781365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER T HORNE Owner 910-573-0861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2013-03-31 |