| NPI | 1790064558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE G CHILTON Sole Member 336-552-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-079-085) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2011-08-11 |