| NPI | 1558969014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA CROMWELL Owner/Administrator 336-210-8273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |