| NPI | 1962238907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNIE VAUGHN PUETT Member/ Manager 828-443-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |