| NPI | 1871084475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK DEXTER POTTER Owner/Operator 919-908-8903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NC S8359) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |