| NPI | 1255781845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC DALTON MORSE Program Sponsor 919-977-5993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NC MHL-092-938) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2020-03-05 |