| NPI | 1619231792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILDA B MOORE Administrator 910-574-9983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC FCL-026-060) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: NC FCL-026-060) |
| 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-026-060) | |
| 347C00000X Private Vehicle (Licence: NC FCL-026--060) | |
| 347E00000X Transportation Broker (Licence: NC FCL-026-060) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |