| NPI | 1255874913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE M TYSINGER Center Director 910-893-5727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NC 12716) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-29 |