| NPI | 1750475547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA PARKER RANDOLPH Director 910-452-9054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-02-12 |