| NPI | 1679693600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE MCLEOD Office Manager 910-867-0215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-026-008) |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2020-08-22 |