| NPI | 1477446490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAISHA MCINTYRE Owner/Manager 919-578-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-05-29 |