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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

GLENN KRYSTLE MANOR
NPI 1700906070
Custodial Care Facility - Adult Care Home in Fayetteville, NC

Active since March 30, 2007
220 DAVIS ST, FAYETTEVILLE, NC 28305(910) 486-8854 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Glenn Krystle Manor NPPES

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

GLENN KRYSTLE MANOR (NPI 1700906070) is a healthcare organization registered as an adult care home in Fayetteville, North Carolina and active in the NPI registry since March 2007. The organization lists Cynthia Danetta Garrison, Administrator/owner, as its authorized official.

NPPES Registry Identity

NPI1700906070
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameGLENN KRYSTLE MANOR
Location Address220 DAVIS STFayetteville, NC 28305-5346
Mailing Address1887 Spiralwood DrFayetteville, NC 28304-0499 · (910) 527-4673
Phone(910) 486-8854
Organization SubpartNo
Authorized OfficialCynthia Danetta GarrisonAdministrator/owner · (910) 527-4673
Enumeration DateMarch 30, 2007
Last NPPES UpdateJune 24, 2026
NPPES CertifiedJune 24, 2026
✔ NPI 1700906070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in NC · FCL-026-049
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
220 DAVIS ST, Fayetteville, NC 28305
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Other Identifiers 1

Medicaid7805650NC

Other Providers at the Same Location NPPES

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

BRANDIN MANOR FCH
Residential Treatment Facility, Physical Disabilities
220 DAVIS ST
FAYETTEVILLE, NC 28305
Cumberland County (910) 527-9898

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 Glenn Krystle Manor's NPI number?

The NPI number for Glenn Krystle Manor is 1700906070. It was assigned to this organization in the NPPES registry on March 30, 2007.

Where is Glenn Krystle Manor located?

Glenn Krystle Manor is located at 220 Davis St, Fayetteville, NC 28305. The listed phone number is (910) 486-8854.

What is Glenn Krystle Manor's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Glenn Krystle Manor was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 49 days 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.