| NPI | 1528259967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HATTIE DUNHAM Authorized Official 919-697-7340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness (Licence: NC MHL-032-411) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2025-09-02 |