| NPI | 1124418595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC CONRAD BRAKE Administrator 252-443-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC Fcl064-027) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-03-04 |