| NPI | 1962102830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY LAWRENCE Owner 910-632-0562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2026-03-06 |