| NPI | 1689818221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DEAN WILSON Managing Member 336-495-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC HAL-054-067) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2013-06-13 |