| NPI | 1730207960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J. GRAVES Owner 336-228-9376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC MHL-001-097) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |