| NPI | 1649503087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN VENABLE Owner/Member Organizer 919-824-3003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 24701) |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2009-09-17 |