| NPI | 1679770317 |
|---|---|
| Doing Business As | PORT SOUTH VILLAGE |
| Entity Type | Organization |
| Authorized Contact | RHONDA LOCKAMY Secretary 910-814-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC HAL-065-025) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |