| NPI | 1043812506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNIE VAUGHN PUETT Member/Manager 828-764-4864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2020-11-10 |