| NPI | 1720313976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA K PETERSON Member Manager 704-502-3210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC HAL049028) |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2009-11-17 |