| NPI | 1659049351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAGET AYANA TEGEGNE Mr 704-963-5277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |