| NPI | 1639989353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN GROVE Director 919-627-7367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-01-14 |