| NPI | 1538539077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELWYN GEORGE DANIEL CEO 252-907-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2015-09-27 |
| Last Update Date | 2015-09-27 |