| NPI | 1902028228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MCINTYRE Clinical Director 252-353-4968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 4144) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2011-02-23 |