| NPI | 1346523800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY LOCKLEAR CFO/Credentialing Specialist 910-865-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2020-09-02 |