| NPI | 1225538267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE LANE FREDERIKSEN Nurse Practitioner, CEO 910-200-2537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC 182435) |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2022-09-28 |