| NPI | 1417002684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABETHA TENIKA BAKER Executive Director 336-274-6874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-041-744) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |