| NPI | 1184960775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LAVON MCDONALD Program Development 910-895-6270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 077073) |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2012-12-31 |