| NPI | 1518716802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MARIE SIMPSON Clinical Director 336-280-0371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-05-17 |