PELHAM SUPPORTIVE SERVICES NPI 1225339054

NPI Information

NPI: 1225339054
Provider Name: PELHAM SUPPORTIVE SERVICES
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
949 COUNTRY CLUB DR
FAYETTEVILLE, NC
ZIP 28301
Phone: (910) 630-6757
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PELHAM SUPPORTIVE SERVICES is a community based residential treatment facility mental illness in Fayetteville, NC. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. PELHAM SUPPORTIVE SERVICES NPI is 1225339054. The provider is registered as an organization entity type.

The provider's business location address is:

949 COUNTRY CLUB DR
FAYETTEVILLE, NC
ZIP 28301-907
Phone: (910) 630-6757
Fax: (910) 884-9806

The provider's authorized official is Mildred C Wilson .
The authorized official title is Director and has the following contact phone number (910) 630-6757.

The enumeration date for this NPI number is 11/10/2010 and was last updated on 11/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		MHL-026-823	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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