| NPI | 1639394539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARISSA B ELLISON Administrator 336-349-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC FCL-079-040) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |