| NPI | 1962886143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANMEKA COBB Director/Owner 252-218-9228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-11-01 |