| NPI | 1881806602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED SURGEON Director 910-733-0617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2024-08-07 |