| NPI | 1497002745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIA ANTOINETTE JONES Administrator 910-465-0427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2012-08-06 |