| NPI | 1295515393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE DAVID RUNNELS Director 919-601-6442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2024-11-25 |