| NPI | 1265584767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYE NEW Owner 910-938-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2015-09-17 |