| NPI | 1407843097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER DEFELICE Administrator 704-263-1986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NC NH0386) |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) (Licence: NC NH0386) |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NC NH0386) | |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC NH0386) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2009-11-19 |