| NPI | 1467741058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERENDA LATRICE WILLIAMS CEO 252-883-1670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 033097) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-04 |