| NPI | 1922994755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY LEATH MARK Owner/Manager 336-254-8531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 207PE0004X Emergency Medicine, Emergency Medical Services | |
| 101YM0800X Counselor, Mental Health | |
| 103TP0814X Psychologist, Psychoanalysis | |
| 1223G0001X Dentist, General Practice | |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-06-17 |