| NPI | 1700905221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY L JOHNSON Owneroperator 336-323-2718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness (Licence: NC 041771) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-07-24 |