| NPI | 1447431689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA JEAN WATERS Owner 919-922-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL096197) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2007-11-15 |