| NPI | 1366777286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANISSA YVETTE JOHNSON Billing Clerk 910-671-4067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-078-179) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |