| NPI | 1386924736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEAL BUSTEED Program Manager 910-686-5614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NC 7623) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-08-17 |