| NPI | 1609916279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES VINSON GRAHAM Owner 910-608-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC HC1604) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2009-02-04 |