| NPI | 1821469198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDRAKE LEWIS CEO 919-790-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2021-12-02 |