| NPI | 1750587333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMULUS THURMAN WATLINGTON Administrator 336-254-9662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FLC-041-034) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2007-12-03 |