| NPI | 1225312762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY RAY BULLOCK CEO 252-373-3213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NC MHL-098-174) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2011-11-23 |