| NPI | 1235890625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ADDO Administrator 919-259-9068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-01-06 |