| NPI | 1841481926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA FOWLER Executive Director 336-229-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |