| NPI | 1104936103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA L GWYNN Owner/Administrator 336-349-3610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC FCL-079-054) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-05-20 |