| NPI | 1285968818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT BEAVERS Credentialing Manager 919-210-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2023-01-18 |