| NPI | 1538500905 |
|---|---|
| Doing Business As | LANE ST RETIREMENT HOME |
| Entity Type | Organization |
| Authorized Contact | LAWANDA RAY Owner 336-229-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC HAL-001-149) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |