| NPI | 1023342250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES B GLADDEN Mbr/Admin 336-508-5569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2009-09-21 |