| NPI | 1932570488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY WAMSLEY Executive Director 919-917-0609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC LCAS-3115) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: NC 1043564271) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2017-03-30 |