| NPI | 1811430267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON BRYANT Owner 252-813-1939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-033-009) |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2016-12-01 |