| NPI | 1710002258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA T HICKS Controller 252-826-4144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NC 9047) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |