| NPI | 1093817207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEA O GWYNN Owner Administrator 336-349-3610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC FCL-079-012) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-08-22 |