| NPI | 1891226858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT K MATLACK Owner 910-323-1543 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200201282) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2021-02-08 |