| NPI | 1871642413 |
|---|---|
| Doing Business As | WHITE STORE FAMILY CARE HOME |
| Entity Type | Organization |
| Authorized Contact | WILLIE EVANS Owner 704-296-5162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC FCL090012) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2008-06-26 |