| NPI | 1275967077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOGAN GRADDY Owner 919-475-9160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NC 2007000070) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2013-08-28 |