| NPI | 1700144573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERTA SHORT PETTIFORD Administrator 336-599-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL073013) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2012-04-30 |