| NPI | 1669049532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD VIETS Program Sponsor/Managing Partner 910-770-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2024-04-23 |