| NPI | 1215341649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OJETTA DIONNE MILEY Afl Provider / Director 919-828-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC 4334523) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |