| NPI | 1750821229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACY MELISSA HAMM Sponsor 919-656-1633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NC MHL-067-166) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: NC MHL-067-166) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2023-10-30 |