| NPI | 1720380660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WOODSON Adminstratior 336-349-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL079081) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2010-11-29 |