| NPI | 1497939664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KING Owner 704-531-0359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FLC-060-088) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2012-09-05 |