| NPI | 1700661931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY EDMISTER Owner 910-830-3064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-28 |