| NPI | 1194124362 |
|---|---|
| Doing Business As | IN-HOUSE |
| Entity Type | Organization |
| Authorized Contact | FERNANDO ENRIQUE ARIZA President/Owner 336-245-9519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 2001-01309) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: NC 2001-01309) |
| 282E00000X (Licence: NC 2001-01309) | |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2021-01-15 |