| NPI | 1689711731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELECIA SHACKLEFORD Owner 252-747-7615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL-040-025) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |