| NPI | 1780338566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTELLA JOANN SPANN Owner / Supervisor In Charge 336-694-1878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2022-02-09 |