| NPI | 1366787038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CARSON MCCOLLUM President 919-491-1085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC fcl054066) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |