| NPI | 1740052059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY HOWARD Owner/Administrator 704-712-2263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 177F00000X Lodging |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |