| NPI | 1083918205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BREWER Contract Administrator 919-783-8898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251S00000X |
| 251B00000X Case Management | |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2016-01-12 |