| NPI | 1265742415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDA S DODSON CEO 910-261-4570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |