| NPI | 1245967553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNIE LEE HUNSUCKER Owner/Administrator 336-267-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2022-08-16 |