| NPI | 1760376776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRITA N LONG Owner 919-339-9540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-07-16 |