| NPI | 1235370099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE HOLMAN Administrator 336-340-8696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2009-03-08 |
| Last Update Date | 2009-03-08 |