| NPI | 1124153382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOUSTON MCLEAN Owner 910-263-0798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL026040) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |