| NPI | 1376217810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY R FRINK Owner 910-309-6569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2021-08-07 |
| Last Update Date | 2021-08-07 |