| NPI | 1710005939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARNETTA E MOORE Administrator 336-226-8237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC FCL-001-114) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2008-06-24 |