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

Pelham Supportive Services

Organization Mental Illness Community Based Residential Treatment Facility · NPI 1053626135

Pelham Supportive Services is a Mental Illness Community Based Residential Treatment Facility in Fayetteville, North Carolina. Licensed in North Carolina. Registered with an NPI since 2010.

Licensed in
NC
In the registry since
2010

Practice location Address checks out

2226 Memory St
Fayetteville, NC 28304-5827
Phone: (910) 429-0081
Fax: (910) 884-9806
Show map & directions

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

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X · Licence MHL-2620 (NC)

Record details

NPI number1053626135
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mildred Wilson — Owner · (910) 630-6757
Other names Pelham Group Home #4
NPI enumeratedAugust 12, 2010
Last updated in NPPESAugust 12, 2010
Mailing address949 Country Club Dr, Fayetteville, NC 28301-2907

Other providers in Fayetteville