| NPI | 1801070719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER DANIEL SHANNON Owner/M.D. 252-523-2781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC 200301170) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2010-11-05 |