| NPI | 1588948939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD EDWARDS Contract Administrator 919-783-8898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-098-168) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2015-11-20 |