| NPI | 1245471101 |
|---|---|
| Other Name | PORT SOUTH VILLAGE- TARA |
| Entity Type | Organization |
| Authorized Contact | RHONDA LOCKAMY Business Office Manager 910-890-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC HAL-065-025) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2009-03-23 |