| NPI | 1417310186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALAN CARPENTER Sole LLC Agent 405-343-1585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC C010058) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |