| NPI | 1942719794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLON MOORE Owner/Registered Agent 336-987-3014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: NC hc3616) |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: hc3616) |
| 385H00000X Respite Care (Licence: NC hc3616) | |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2017-09-25 |