| NPI | 1710133137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA A WOODSON Administrator 336-349-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-079-016) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2024-03-15 |