| NPI | 1124493945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAZEL J SPRUILL Owener 336-350-2690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC fcl-001-162) |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2015-12-04 |