| NPI | 1508378951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY T HINES Director 571-330-2829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 13289) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2018-03-17 |