| NPI | 1710577184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA CONSUELA PERKINS Owner 919-943-9515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-01-20 |