| NPI | 1679757678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMAN LOIUS WARRICK Owner 252-937-7958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC FCL-064-017) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |