| NPI | 1770856098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA JEAN WILLIAMS Cna 336-599-8366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 56-1082674) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2012-02-16 |