| NPI | 1235291519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DEVON WILSON Program Coordinator 919-872-1178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 8301768) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |