| NPI | 1215122114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MOIR STRICKLAND Program Manager 336-436-0074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2013-06-06 |