| NPI | 1487190401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL G MITCHELL Administrator 919-630-7103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2017-01-14 |
| Last Update Date | 2017-01-14 |