| NPI | 1245637701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PUNITHA RATHNAM Owner/Md 252-686-8093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 2010-01045) |
| Enumeration Date | 2014-11-28 |
| Last Update Date | 2014-12-19 |