| NPI | 1770335382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT TURNER BEAVERS Credentialing Manager 919-210-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-04-05 |