| NPI | 1417386103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE A FREDERICK Owner 704-904-6246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC 406971) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |