| NPI | 1912190216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY MAYNOR Administrator 910-521-7335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL078098) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2014-06-04 |