| NPI | 1215731062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALORA BLACKWELL Admin 252-400-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2025-04-02 |
| Last Update Date | 2025-04-02 |