| NPI | 1235491507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE SHAVONE BROWN Owner 252-820-0652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-039-055) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |