| NPI | 1316780208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGONDA-YEBENIT NGOMAYEBA Owner 910-536-2272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-09-11 |