Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fayetteville Street Community Living Home

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1295998029

Fayetteville Street Community Living Home is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Durham, North Carolina. Licensed in North Carolina. Registered with an NPI since 2008.

Licensed in
NC
In the registry since
2008

Practice location Address checks out

111 N Maple St
Durham, NC 27703-3021
Phone: (919) 519-0016
Fax: (919) 596-0645
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X · Licence MHL032445 (NC)

Record details

NPI number1295998029
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robin Williams — Administor · (919) 519-0016
NPI enumeratedJuly 2, 2008
Last updated in NPPESDecember 12, 2013
Mailing address111 N Maple St, Durham, NC 27703-3021

Other providers in Durham