| NPI | 1104133297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELECHA CORLEY FOUNTAIN Managing Member 919-798-8098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-092-163) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-09-10 |