| NPI | 1750501698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY PULLIAM Administrator 336-449-5418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC 041-031) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |