| NPI | 1689841298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARISE KIMBERLY FRASIER President/Clinical Director 910-265-4666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QD1600X Clinic/Center Developmental Disabilities |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |