MRS. DIANNE GIBSON NPI 1194875658

NPI Information

  • NPI: 1194875658
  • Provider Name: MRS. DIANNE GIBSON
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Individual
  • Address: 2901 BAKERS MILL RD
    FAYETTEVILLE, NC
    ZIP 28306
  • Phone: (910) 423-8816

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NPI Details

MRS. Dianne Gibson is a community based residential treatment facility, intellectual and/or developmental disabilities in Fayetteville, NC. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. MRS. Dianne Gibson NPI is 1194875658. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2901 BAKERS MILL RD
FAYETTEVILLE, NC
ZIP 28306-273
Phone: (910) 423-8816
Fax: (910) 423-8816

The enumeration date for this NPI number is 1/10/2007 and was last updated on 7/9/2007.

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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13409525MEDICAIDNORTH CAROLINA

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: 3/30/2025

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