| NPI | 1376922062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLISSIE PETERSON Program Director 336-437-4382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC mhl-001-230) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2018-07-13 |