| NPI | 1922128131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIA ALVARADO Aministrator 336-222-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC FCL001101) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-06-26 |