| NPI | 1659653053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON WELLMAN Owner 919-345-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-051-194) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-12-13 |