| NPI | 1811288574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASHEBA KEY-ALLRED Credentialing Specialist 919-865-8632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC MHL-065-223) |
| Additional Taxonomies | 251S00000X |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2018-09-24 |