| NPI | 1891882528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAYCE CROCKETT Area Director 704-336-8638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2022-07-21 |