| NPI | 1063286011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASIM KHOGALI Manager 336-255-5507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2024-02-05 |