| NPI | 1518465368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYKEIA CLAY Administrator/Owner 336-343-5295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2018-01-26 |