| NPI | 1760950570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA H HOWARD Administrator 704-470-5761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-11-09 |