| NPI | 1265845028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMIE TAYLOR Administrator 910-309-1730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-078-099) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2014-07-14 |