| NPI | 1902172885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMENIA MILTON Owner 336-987-2474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC MHL-041-1030) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2012-03-26 |