| NPI | 1972630614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORETTA R. WILSON ALEXANDER Supervisor In Charge 336-227-5216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-001-089) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2008-06-26 |