| NPI | 1396514238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN W EDWARDS Owner 910-922-5408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |