| NPI | 1699567958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE REGAN FAWCETT Member And Organizer 910-208-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-05-21 |
| Last Update Date | 2025-05-22 |