| NPI | 1720085293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA BENTON PARNELL Administrator 910-646-3132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: NC 5030990001) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: NC 5030990001) | |
| 314000000X Skilled Nursing Facility (Licence: NC NH0246) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2011-11-02 |