| NPI | 1891124921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE SMITH YELVERTON Executive Program Director 919-961-5123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 2006-05-001) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |