| NPI | 1932667607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD SWAYNE Owner 336-443-5445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-09-30 |