| NPI | 1154902120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA HOPE LEA Administrator 336-524-7618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-04-22 |