| NPI | 1730875303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASIM KHOGALI Manager 336-255-5507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2024-02-05 |