| NPI | 1891959524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERIC BOSTON Owner 919-619-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC C006078) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2012-05-21 |