| NPI | 1073118816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRY TIRRELL HINGLETON CEO 336-587-7027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2021-08-05 |