| NPI | 1811024698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN GOLDMAN-OWENS Fiscal Agent 434-848-0294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC HAL-072-006) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |