| NPI | 1902228943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFANIE RUDD Ex.Dir. 336-907-7268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2014-01-10 |