| NPI | 1851694814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENTIERS ANTARIO LONDON Co Owner 252-634-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC MHL032446) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2010-12-14 |