| NPI | 1205197803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY B JONES CFO 704-986-1522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-084-040) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 251S00000X | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2021-03-31 |