| NPI | 1790535037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MARIE KING Owner/Director 910-987-9448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-04-09 |