| NPI | 1659783058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLY KEITH IDELL President/Owner 828-200-3739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC C201412200314) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |