| NPI | 1851604599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONITA MCKOY Therapist 336-765-8912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 1041C0700X) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2010-07-23 |