| NPI | 1447433099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAD DAVIS Owner/Director 910-865-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2009-02-24 |