| NPI | 1770771750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADHUR MITTAL President 910-353-0581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NC 3758) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2020-07-08 |