| NPI | 1710671441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIJUANA DELROYA WHITE Owner 910-528-7921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |