| NPI | 1992152847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BERNARD QUICK Owner 336-509-3475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 7277101979) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-05-20 |