| NPI | 1619691185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY DIX MCHUGH Administrator/Owner 336-222-8913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-09-28 |