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Fayetteville Street Community Living Home
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Durham, North Carolina
NPI 1295998029

Fayetteville Street Community Living Home is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Durham, NC. Fayetteville Street Community Living Home practices in Durham, NC. The NPI Number for Fayetteville Street Community Living Home is 1295998029 and holds a License No. MHL032445 (North Carolina).

The current practice location address for Fayetteville Street Community Living Home is 111 N Maple St, Durham, NC and can be reached out via phone at 919-519-0016 and via fax at 919-596-0645.

Location: 111 N Maple St, Durham, NC, 27703-3021
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1295998029
Provider Name
Fayetteville Street Community Living Home
Credential
Provider Entity Type
Organization
Address
111 N Maple St, Durham, NC, 27703-3021
Phone Number
919-519-0016
Fax Number
919-596-0645
Provider Enumeration Date
07/02/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
111 N Maple St
City
Durham
State
North Carolina
Zip
27703-3021
Phone Number
919-519-0016
Fax Number
919-596-0645
person
Provider Business Mailing Address Details
Address
111 N Maple St
City
Durham
State
North Carolina
Zip
27703-3021
Phone Number
919-519-0016
Fax Number
919-596-0645
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
MHL032445 (North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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