NPI | 1962538694 |
---|---|
Entity Type | Organization |
Authorized Contact | FONDA CLARK Administrator 910-234-0655 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC mhl024-058) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2020-08-22 |