| NPI | 1801121140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN DENISE CLARKE Owner 252-426-3496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: NC MHL-072-008) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2023-12-15 |