| NPI | 1790957769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO MCMILLIAN Owner 910-272-9107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NC MHL-078-205) |
| Enumeration Date | 2008-03-30 |
| Last Update Date | 2008-03-30 |