| NPI | 1689002412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE DAVID Administrator 910-483-5448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-10-14 |