| NPI | 1306884069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD BOOKER CEO 336-370-9232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 251B00000X Case Management | |
| 207K00000X Allergy & Immunology | |
| 251S00000X Community/Behavioral Health | |
| 207KA0200X Allergy & Immunology, Allergy | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2018-06-22 |