| NPI | 1265637516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET CAMPBELL Administrative Supervisor In Charge 704-872-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: NC FCL-049-001) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2008-07-02 |