| NPI | 1740278126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMAN DAVIS Administrator 252-492-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NC nh0477) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: NC nh0477) |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NC nh0477) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2008-06-19 |