| NPI | 1104999820 |
|---|---|
| Other Name | WILLOWBROOKE ADULT GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | LINDA FAYE HORNE President Administrator 276-336-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |