| NPI | 1801037247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMENIA MILTON Owner 336-279-1192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC MHL041835) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2009-03-16 |