| NPI | 1184372500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEATRICE BONNIE CAMPBELL Owner 919-571-9114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-03-15 |