| NPI | 1417420464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL BUSH Organizer 919-539-8520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-01-02 |