| NPI | 1376813600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKITA BLAKENEY Owner/Administrator 980-275-0698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-041-076) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-03-12 |