| NPI | 1386081909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA VONZELL FOWLER Owner/Adminstrator 336-228-7897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2013-05-23 |