| NPI | 1346394814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA LEACH Administrator 910-630-1946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities (Licence: NC FCL 026 017) |
| Additional Taxonomies | 261QD1600X Clinic/Center Developmental Disabilities (Licence: NC FCL 026 037) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2008-05-05 |