| NPI | 1861084402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIN OXENDINE-MYERS Owner/Operator 910-885-8813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2023-09-06 |