| NPI | 1316150105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN GRAVES Administrator 336-222-1462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL001014) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2009-06-10 |