| NPI | 1679996995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA LITTLE Nc State Qi & Training Director 704-344-0491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2015-01-20 |