| NPI | 1700169695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA H HENDRIX Program Director 336-587-8876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |