| NPI | 1952676330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOTEKA OGBURN JENKINS Vice President 252-213-0489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1670) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |