| NPI | 1699212555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNELL M SIMPSON Administrator 336-613-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL079104) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2022-11-02 |