| NPI | 1316337033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENAE LASANDRA WHITEHEAD Owner 910-382-3594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 8992) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |