| NPI | 1982891560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL JOHNSON Administrator 704-637-3784 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: NC NH0197) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2010-01-13 |