| NPI | 1770707929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE LENORE LEWIS Owner 336-589-8197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC FCL-079-058) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |