| NPI | 1952614174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF HIXON BEARD Contract Physician 251-621-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: AL 2819) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2010-07-16 |