| NPI | 1700117579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFREIDA BROOKS Owner 910-374-7187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-078-080) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-078-050) |
| 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-078-027) | |
| 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-078-049) | |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2024-02-01 |