| NPI | 1821346024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWANDA RAY Owner 336-534-1416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL001-144) |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2012-08-17 |