| NPI | 1194070771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL WORTHINGTON Supervisor 336-965-5922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-19 |