| NPI | 1487786919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEVON ANTONIO CARPENTER Director Of Operations 336-788-7929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-03-11 |
| Last Update Date | 2008-07-30 |