| NPI | 1962556696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASHEBA YVETTE KEY-ALLRED Credentialing Specialist 919-865-8632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2021-03-09 |