| NPI | 1275371015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESHON WISE Director 919-671-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-17 |