| NPI | 1992984215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIT-TENA FERGUSON Agency Director/Program Coordinator 336-299-0838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2007-11-02 |