| NPI | 1700079357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE LONG Owner 336-694-9994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-017-021) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |