| NPI | 1689441586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENESHA DEGRAFFENREID Executive Director 980-850-9087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2023-12-11 |