| NPI | 1265058234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L SHAW President 252-563-2817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2020-06-24 |