| NPI | 1568918969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AL DAVIS Owner 980-234-2910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL080030) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL080028) |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL080029) | |
| Enumeration Date | 2016-08-27 |
| Last Update Date | 2016-08-27 |