| NPI | 1700039104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA SIMON Billing Officer 252-633-3855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2010-09-17 |