| NPI | 1407049448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDEN ALDRIC HARGETT Program Manager Operations 336-641-3019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |