| NPI | 1114126224 |
|---|---|
| Doing Business As | WATERBROOKE OF ELIZABETH CITY |
| Entity Type | Organization |
| Authorized Contact | DAVID BURNS GOLDSTON President 910-754-6621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |