| NPI | 1275968679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A HUMPHREY Director 336-448-0096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-017-032) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2014-09-26 |