| NPI | 1447457379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES VINCEN GRAHAM Owner 910-608-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-078-162) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2010-10-04 |