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 |