| NPI | 1851681571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GYASI EDWARDS Administrator 919-489-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL-032-105) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |