| NPI | 1013459643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS H REID Owner 252-281-3967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL098033) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |