| NPI | 1710278676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYRON V MOORE Program Director 336-226-8237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC MHL-001-210) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |