| NPI | 1245444009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LACY JENKINS Owner 251-650-5360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 21736) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2013-06-15 |