| NPI | 1265649339 |
|---|---|
| Former Legal Business Name | DEVEREAUX HOME |
| Entity Type | Organization |
| Authorized Contact | SHARON EDWARDS DEGRAFFENREID Administrator 704-785-8225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |