| NPI | 1457476913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZELMA JACKSON WOLFE Adminstator 335-722-8354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL034020) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2008-07-11 |