| NPI | 1497097208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MARTIN Director Of Clinic Operations 251-435-1360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-119026) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: AL 1-119026) |
| 273Y00000X Rehabilitation Unit (Licence: AL 1-119026) | |
| 282N00000X General Acute Care Hospital (Licence: AL 1-119026) | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2013-03-19 |