| NPI | 1427250315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE G WILSON Administrator 252-348-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-008-020) |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2007-07-18 |