| NPI | 1801986658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY EDWIN JACKSON Vice President Secretary Clinical D 910-362-9474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-08-25 |