| NPI | 1609241108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYBRA SAUNDERS Owner 252-526-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |