| NPI | 1508993866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LANE MORRIS Administrator 704-633-1985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC HAL080-006) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2008-07-31 |