| NPI | 1023148434 |
|---|---|
| Other Name | LIGHT HOUSE VILLAGE |
| Entity Type | Organization |
| Authorized Contact | JACQUELINE W PIERCE Managing Member 336-643-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC HAL-067-013) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: NC HAL-067-013) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2023-11-13 |