| NPI | 1386134724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS DAYOM WATKINS Owner 910-574-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 7823) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2020-03-15 |