| NPI | 1609248855 |
|---|---|
| Other Name | COUNTRY LIVING ESTATES ASSISTED LIVING FACILITY |
| Entity Type | Organization |
| Authorized Contact | HILDA MOORE Administrator 910-484-1701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 344600000X Taxi | |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |