| NPI | 1154528222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE K MBURU President 919-754-0529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCH092129) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: NC FCH092129) |
| Enumeration Date | 2007-07-01 |
| Last Update Date | 2009-08-26 |