| NPI | 1952445090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA G. PACKINGHAM Administrator 336-222-0114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: NC FCL-001-118) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2012-11-27 |