| NPI | 1780920033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS TODD SHEPARD CFO 910-212-2261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ BH-4071) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-13 |