| NPI | 1710265301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANISHA CONRAD DICKENS Owner 919-225-0167 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-032-110) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: NC FCL-032-110) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2023-11-16 |