| NPI | 1346662384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN SINGLETON Owner 336-501-8792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NC 900281) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2014-01-10 |