| NPI | 1932389475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA Y CLODFELTER Vice President 336-449-9775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-11-19 |