| NPI | 1376815365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEOSHA L HOUSTON Owner 615-426-6174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-040-009) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-02-06 |