| NPI | 1306176086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLITA MOUJAHED Administrator 910-318-9667 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-078-074) |
| Enumeration Date | 2010-01-03 |
| Last Update Date | 2010-01-03 |