| NPI | 1376771527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE P. MOORE Manager 336-226-0337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC MHL-001-173) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2009-06-26 |