| NPI | 1497152532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALID GREENAWAY Clinical Director 336-253-5286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 5796) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NC 9787) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |