| NPI | 1376076638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA WATLINGTON Administrator 336-340-6856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-079-108) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |