| NPI | 1174765010 |
|---|---|
| Other Name | PORT SOUTH VILLAGE- TERESA |
| Entity Type | Organization |
| Authorized Contact | RHONDA LOCKAMY Business Office Manager 910-762-4550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC HAL-065-028) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |