| NPI | 1588979140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WEAVER Member 919-295-4771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2010-08-06 |