| NPI | 1609418821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLISTINE SIMMONS Chief Executive Officer 252-287-3562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2023-01-19 |