| NPI | 1548771983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ASHLEY MIZELLE Owner/Clinical Administrator 252-814-5441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-10-12 |