| NPI | 1386465805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYNEQUA WYNESSA CHAPARIS-CRAWFORD Owner/Provider 336-937-5832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |