| NPI | 1982723607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J GRAVES Owner 336-228-9376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC FCL001078) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-02-12 |