| NPI | 1730580432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERVIN DAVIS CEO 919-605-9981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 091095) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2014-09-12 |