| NPI | 1376685800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERMA J EVANS Owner 336-584-1968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC FCL-001-051) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |