| NPI | 1295083467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE MAE BAKER Administrator 919-269-5852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-092-173) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |