| NPI | 1790966232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY MAYNOR Administrator 910-521-7335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL078096) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2014-06-04 |