| NPI | 1639355001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE WILLIAMS Provider Enrollment 252-915-0122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |