| NPI | 1164698429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA O KIRKLAND Administrator 336-436-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2012-08-01 |