| NPI | 1396984373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER G. GORE Owner 910-641-0600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2011-08-30 |