| NPI | 1346201340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LEIGH FOREHAND Managing Partner 910-763-2476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NC 28410) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-07-13 |