| NPI | 1801105408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA WILLETT CEO 252-258-8632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NC MHL096269) |
| Additional Taxonomies | 251S00000X |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: NC MHL098191) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: NC MHL053078) | |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2023-11-17 |