| NPI | 1679188460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA GREENE Administrator 252-209-7238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2024-03-05 |