| NPI | 1205593910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARNETTA MCADAMS Administrator 336-263-6860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2021-11-17 |