| NPI | 1639757818 |
|---|---|
| Doing Business As | ADULT HOME |
| Entity Type | Organization |
| Authorized Contact | ARTANZA SHAW President 336-726-4605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-08-24 |