| NPI | 1245406065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON YATES Program Director 336-886-5594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 6006552) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2012-02-24 |