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Concordia Support Services, Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Fayetteville, North Carolina
NPI 1417045188

Concordia Support Services, Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Fayetteville, NC. Concordia Support Services, Llc practices in Fayetteville, NC. The NPI Number for Concordia Support Services, Llc is 1417045188 and holds a License No. (North Carolina).

The current practice location address for Concordia Support Services, Llc is 2315 Bloom Avenue, Fayetteville, NC and can be reached out via phone at 910-826-8253 and via fax at 910-826-8254.

Location: 2315 Bloom Avenue, Fayetteville, NC, 28314-5018
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1417045188
Provider Name
Concordia Support Services, Llc
Credential
Provider Entity Type
Organization
Address
2315 Bloom Avenue, Fayetteville, NC, 28314-5018
Phone Number
910-826-8253
Fax Number
910-826-8254
Provider Enumeration Date
10/10/2006
Last Update Date
03/12/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
8300606 05 NC
8301129G 05 NC
6603837 05 NC
8300606B 05 NC
8300606G 05 NC
6006251 05 NC
6603570 05 NC
8300604 05 NC
8300605B 05 NC
8301129H 05 NC
6603687 05 NC
8300605 05 NC
5950244 05 NC
8301864B 05 NC
83001129B 05 NC
8300604B 05 NC
8301129 05 NC
8301864 05 NC
institution
Provider Business Practice Location Address Details
Address
2315 Bloom Avenue
City
Fayetteville
State
North Carolina
Zip
28304-6165
Phone Number
910-826-8253
Fax Number
910-826-8254
person
Provider Business Mailing Address Details
Address
2315 Bloom Avenue
City
Fayetteville
State
North Carolina
Zip
28304-6165
Phone Number
910-826-8253
Fax Number
910-826-8254
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Day Training, Developmentally Disabled Services
Speciality
-
Taxonomy
251C00000X
License No.
MHL-067154 (North Carolina)
Definition
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.
person
Provider's Taxonomy Details 2
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
MHL-067-156 (North Carolina)
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
()
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.
person
Provider's Taxonomy Details 4
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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