| NPI | 1992929475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA SUSAN AMBROSE Administrator 910-298-5877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC HAL-031-014) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |