| NPI | 1174915185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENIFER PHELPS Nurse Practitioner / Owner 910-790-9103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NC 900221) |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2015-02-27 |