| NPI | 1588132906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA S EULISS Managing Member / Administrator 336-226-8546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2018-11-03 |
| Last Update Date | 2018-11-03 |