| NPI | 1396128757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICKEYO SENTWAN HUSKEY Adminstrator 704-300-7077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-023-046) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-05 |