| NPI | 1790545051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY GREEN Owner 336-482-1708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-03-21 |