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Pelham Supportive Services
Mental Illness Community Based Residential Treatment Facility in Fayetteville, North Carolina
NPI 1760544712

Pelham Supportive Services is a Mental Illness Community Based Residential Treatment Facility based in Fayetteville, NC. Pelham Supportive Services practices in Fayetteville, NC. The NPI Number for Pelham Supportive Services is 1760544712 and holds a License No. MHL-026-823 (North Carolina).

The current practice location address for Pelham Supportive Services is 1712 Shiloh Dr, Fayetteville, NC and can be reached out via phone at 910-423-2800 and via fax at 910-423-2800.

Location: 1712 Shiloh Dr, Fayetteville, NC, 28301-2907
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1760544712
Provider Name
Pelham Supportive Services
Credential
Provider Entity Type
Organization
Address
1712 Shiloh Dr, Fayetteville, NC, 28301-2907
Phone Number
910-423-2800
Fax Number
910-423-2800
Provider Enumeration Date
12/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7806025 05 NC
institution
Provider Business Practice Location Address Details
Address
1712 Shiloh Dr
City
Fayetteville
State
North Carolina
Zip
28304-4027
Phone Number
910-423-2800
Fax Number
910-423-2800
person
Provider Business Mailing Address Details
Address
1712 Shiloh Dr
City
Fayetteville
State
North Carolina
Zip
28304-4027
Phone Number
910-423-2800
Fax Number
910-423-2800
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
MHL-026-823 (North Carolina)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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