| NPI | 1770603516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SCOTT GODDARD Partner 252-341-5860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 251B00000X Case Management |
| 261QE0002X Clinic/Center Emergency Care | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center Primary Care | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2008-02-21 |