| NPI | 1649589425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTTIE JEFFERY VANHOOK Clinical Director 910-814-4243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NC C002092) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC C002092) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2010-09-30 |