| NPI | 1851692024 |
|---|---|
| Former Legal Business Name | GENESIS DWI SERVICES, LLC |
| Entity Type | Organization |
| Authorized Contact | LATRICE FREEMAN DOCKERY Owner 919-321-6643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2010-11-04 |