| NPI | 1790155299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSIE O OGBONNA Administrator 919-876-4388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2015-09-28 |