| NPI | 1700914595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE EDWARD SPRUILL Administrator 910-628-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-078-015) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |