| NPI | 1528198777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE COLEY Billing Specialist 910-483-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NC MHL-070-037) |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: NC MHL-070-037) |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL-070-033) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: NC MHL-070-037) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-04-14 |