| NPI | 1760622443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDA DODSON CEO 910-705-6711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2016-05-17 |