NPI | 1346816667 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM JOSHUA JOHNSON CEO & Provider 910-778-5455 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2021-05-27 |
Last Update Date | 2022-07-25 |