| NPI | 1508039140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARION WILSON CISSEL Owner 910-848-0216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC mnl047109) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-08 |