| NPI | 1063683480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA ADELLE WOODSON Administrator 336-349-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL- 079-032) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2008-03-13 |