| NPI | 1235312133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVERNE JEFFREYS JONES Administrator/Owner 336-226-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FC1001016) |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2007-12-13 |