| NPI | 1386830248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK W ELLEDGE Vice President 336-679-8852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC NH0265) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-09-24 |