| NPI | 1992990113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY JACOBS Program Director 910-343-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 251S00000X) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2007-09-11 |