| NPI | 1417350687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENAE JERAN HOLLEY Owner/CFO 252-331-3485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 2155) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |