Fayetteville Street Community Living Home
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 StDurham, NC 27703-3021
Phone: (919) 519-0016
Fax: (919) 596-0645
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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 number | 1295998029 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Robin Williams — Administor · (919) 519-0016 |
| NPI enumerated | July 2, 2008 |
| Last updated in NPPES | December 12, 2013 |
| Mailing address | 111 N Maple St, Durham, NC 27703-3021 |
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