| NPI | 1497050363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARNETTA ENOCH MOORE Administrator 336-227-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC FCL-001-131) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2011-01-24 |