| NPI | 1598537151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELLEN ALEM DESSALEGN Owner 704-617-9859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-10-26 |
| Last Update Date | 2023-10-26 |