| NPI | 1780717843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBY WELLMON Administartor 704-538-8026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC HAL023004) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |