| NPI | 1649720889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWIGHT HOWARD LYSNE Director 910-399-3927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200301378) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |