| NPI | 1518344217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JERMAINE CRUMP Owner/Executive Director 980-475-4730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |