| NPI | 1336912245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE LETRICE NESBIT Chief Clinical Officer 980-729-7907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2024-10-03 |