| NPI | 1871916189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE AMELIA JORDAN Owner/Administrator 252-567-7821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NC FCL-064-025) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-01-23 |