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SOUTHERN AVE REST HOME
NPI 1083898589
Clinic/Center - Health Service in Fayetteville, NC

Active since December 20, 2007
1124 SOUTHERN AVE, FAYETTEVILLE, NC 28306(910) 286-8118 Get Directions Write a Review

NPPES record last updated: December 20, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southern Ave Rest Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN AVE REST HOME (NPI 1083898589) is a healthcare organization registered as a health service in Fayetteville, North Carolina and active in the NPI registry since December 2007. The organization lists Neill Jones, Owner, as its authorized official.

NPPES Registry Identity

NPI1083898589
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameSOUTHERN AVE REST HOME
Location Address1124 SOUTHERN AVEFayetteville, NC 28306-1754
Mailing Address1124 Southern AveFayetteville, NC 28306-1754 · (910) 286-8118
Phone(910) 286-8118
Organization SubpartNo
Authorized OfficialNeill JonesOwner · (910) 484-4291
Enumeration DateDecember 20, 2007
✔ NPI 1083898589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
License✔ Licensed in NC · FCL026012
1124 SOUTHERN AVE, Fayetteville, NC 28306
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Other Identifiers 1

Medicaid78033383NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Ave Rest Home's NPI number?

The NPI number for Southern Ave Rest Home is 1083898589. It was assigned to this organization in the NPPES registry on December 20, 2007.

Where is Southern Ave Rest Home located?

Southern Ave Rest Home is located at 1124 Southern Ave, Fayetteville, NC 28306. The listed phone number is (910) 286-8118.

What is Southern Ave Rest Home's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Southern Ave Rest Home was last updated on December 20, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.