| NPI | 1386042554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEE DICKERSON CEO 336-993-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC HAL001156) |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2014-12-19 |