| NPI | 1720273626 |
|---|---|
| Other Name | CHILD ADOLESCENT |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA DENNIS JOHNSON Executive Assistant 919-416-1830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2007-09-13 |