| NPI | 1508982695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCILLE COOPER Owner 919-961-7515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL 092-561) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |