| NPI | 1972790558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL JOHNSON Administrator 704-637-3784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NC NH0197) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |