| NPI | 1720799117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA CABBAGESTALK Owner 910-745-8895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2022-12-07 |