| NPI | 1386010908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVONNIE DEANS Owner 252-446-6613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-064-030) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |