| NPI | 1558594507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC LAMAR ELLIS Owner 919-522-8655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 26452362) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2009-08-25 |