| NPI | 1285218933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN YOLANDA PEACE Medical Director 910-734-6247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2022-02-10 |