| NPI | 1104053883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY JONES CFO 704-986-1522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 251S00000X | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-076-033) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2021-03-31 |