| NPI | 1295087161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE DANIEL Administrator 919-523-4942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-092-851) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2012-10-02 |