| NPI | 1942626668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE B WATLINGTON Owner/Administration 336-253-1621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2014-03-06 |