| NPI | 1780312249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA DORIS HOLDER Owner/Administrator 919-690-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2022-08-18 |