| NPI | 1265865489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY L MEBANE Administrator Owner 336-213-3839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC FCL-001-151) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2013-08-12 |