| NPI | 1306960414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERNISHA ALLANA FONSECA CEO 919-220-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 19067) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |