1. Home
  2. Directory
  3. North Carolina
  4. Fayetteville
  5. Assisted Living Facility
  6. NPI Profile

FAYETTEVILLE MANOR, LLC
NPI 1255571766
Assisted Living Facility in Fayetteville, NC

Active since February 23, 2009CLIA 34D2207904 · Waiver
231 TREETOP DR, FAYETTEVILLE, NC 28311(910) 488-4821(910) 488-5069 Get Directions Write a Review

NPPES record last updated: February 23, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fayetteville Manor, Llc NPPES

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

FAYETTEVILLE MANOR, LLC (NPI 1255571766) is a healthcare organization registered as an assisted living facility in Fayetteville, North Carolina and active in the NPI registry since February 2009. The organization holds a CLIA Waiver certificate valid through December 30, 2026 and lists Thomas Husvar, Member, as its authorized official.

NPPES Registry Identity

NPI1255571766
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameFAYETTEVILLE MANOR, LLC
Location Address231 TREETOP DRFayetteville, NC 28311-0606
Mailing AddressPo Box 9895Fayetteville, NC 28311-9093 · (910) 488-4821 · Fax (910) 488-5069
Phone(910) 488-4821
Fax(910) 488-5069
Organization SubpartNo
Authorized OfficialThomas HusvarMember · (704) 608-0761
Enumeration DateFebruary 23, 2009
✔ NPI 1255571766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in NC · HAL-026-054
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
231 TREETOP DR, Fayetteville, NC 28311
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2207904

Fayetteville Manor · Fayetteville, NC
Active · expires Dec 30, 2026
CLIA Number34D2207904
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 31, 2024
Certificate Expiration DateDecember 30, 2026
Laboratory DirectorTorrey Locklear
Laboratory Phone(910) 488-4821
Laboratory LocationFayetteville Manor231 Treetop Drive, Fayetteville, NC 28311
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLIVIA EDINGER
Occupational Therapy Assistant
231 TREETOP DR
FAYETTEVILLE, NC 28311
Cumberland County (843) 754-5147
REBECCA LEE PTA
Physical Therapy Assistant
231 TREETOP DR
FAYETTEVILLE, NC 28311
Cumberland County (910) 488-4821
INGRID ARCE
Physical Therapy Assistant
231 TREETOP DR
FAYETTEVILLE, NC 28311
Cumberland County (910) 488-4821
MS. MARY CATHERINE DEMENT PTA
Physical Therapy Assistant
231 TREETOP DR
FAYETTEVILLE, NC 28311
Cumberland County (910) 488-4821
NIKKI LYNNE KARDOUNI OT
Occupational Therapist
231 TREETOP DR
FAYETTEVILLE, NC 28311
Cumberland County (910) 488-4821
ADRIENNE MAGILL
Physical Therapy Assistant
231 TREETOP DR
FAYETTEVILLE, NC 28311
Cumberland County (669) 254-0355
KIMBERLY NICOLE JOYCE PTA
Physical Therapy Assistant
231 TREETOP DR
FAYETTEVILLE, NC 28311
Cumberland County (910) 488-4821
FELICIA MONQUE CHRISTIAN COTA/L
Occupational Therapy Assistant
231 TREETOP DR
FAYETTEVILLE, NC 28311
Cumberland County (910) 488-4821

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 Fayetteville Manor, LLC's NPI number?

The NPI number for Fayetteville Manor, LLC is 1255571766. It was assigned to this organization in the NPPES registry on February 23, 2009.

Where is Fayetteville Manor, LLC located?

Fayetteville Manor, LLC is located at 231 Treetop Dr, Fayetteville, NC 28311. The listed phone number is (910) 488-4821.

What is Fayetteville Manor, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Fayetteville Manor, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2207904) is associated with this NPI, valid through December 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fayetteville Manor, LLC was last updated on February 23, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.