| NPI | 1952508939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HASKINS Director 919-693-1067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NC HC3574) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-08-22 |