| NPI | 1710007117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J GRAVES Owner 336-570-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC FCL-001-111) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |