| NPI | 1396948550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY JEAN GRAVES Administrator 336-227-7953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC mhl001-147) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-22 |