| NPI | 1770951303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH LOCKETT GARDNER Physician 336-669-4984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NC 183212) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |