| NPI | 1720313695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FEBBIE GANT WILSON Administrator 336-222-0312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC 001-133) |
| Enumeration Date | 2009-10-12 |
| Last Update Date | 2009-10-12 |