| NPI | 1710397427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY MAYNOR Administrator 910-827-9270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-078-096) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2014-05-02 |