| NPI | 1669510905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY L. FIELDS Administrator 252-792-6343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-058-008) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |