| NPI | 1972259620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MARIE SIMPSON Executive Director 336-342-9504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-07-11 |