| NPI | 1528692670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISHA NIKITA EVANS Chief Operating Officer/Director 910-479-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-29 |