| NPI | 1568918415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NETTIE ROSE CLARKE Owner 336-383-9932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 10171) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |