| NPI | 1154462372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PHYLLIP COX Owner 252-291-4915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC MH098095) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |