| NPI | 1689217564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EKLUND Authorized Official 252-638-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2026-04-13 |