| NPI | 1386997369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA WALSON Co Owner 336-848-9064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 143906) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 363LC1500X Nurse Practitioner, Community Health (Licence: NC 143906) | |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2012-10-16 |