| NPI | 1992790810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILES E STANLEH Administrator 336-643-6301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NC NH0226) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: NC NH0226) |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NC NH0226) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2025-09-11 |