| NPI | 1477858678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARNETTA ENOCH MOORE Director 336-506-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC MHL-001-207) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-19 |