| NPI | 1790819357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHEL WELLMON Owner 704-482-0596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC FCL023005) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-06-12 |