| NPI | 1790979193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SPENCER PETTIFORD Owner 919-599-3691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC 032-406) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2008-07-10 |