| NPI | 1407993413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON W CASTEEN Administrator 910-289-2435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC HAL 031-008) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |