| NPI | 1891201042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONDRA ANJANETTE LITTLE Administrator 984-227-2543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-032459) |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2017-12-26 |