| NPI | 1780935395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JAY HEADEN Md/CEO 336-279-1227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 9400266) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2012-09-21 |