| NPI | 1578915849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY SHAW President 919-224-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |