| NPI | 1619666534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE SMITH Practice Manager 910-339-1572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-30 |