| NPI | 1528478237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REUBEN BLACKWELL Chief Executive Officer 252-212-3480 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2015-07-28 |