PELHAM GROUP HOME #2
NPI 1710144738
Community Based Residential Treatment Facility, Mental Illness in Fayetteville, NC
About Pelham Group Home #2 NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PELHAM GROUP HOME #2 (NPI 1710144738) is a healthcare organization registered as a community based residential treatment facility, mental illness in Fayetteville, North Carolina and active in the NPI registry since May 2008. The organization lists Mildred Wilson, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 Pelham Supportive Services's NPI number?
The NPI number for Pelham Supportive Services is 1710144738. It was assigned to this organization in the NPPES registry on May 19, 2008. The provider is doing business as Pelham Group Home #2.
Where is Pelham Supportive Services located?
Pelham Supportive Services is located at 4906 Redwood Dr, Fayetteville, NC 28304. The listed phone number is (910) 826-2990.
What is Pelham Supportive Services's specialty?
The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
When was this NPI record last updated?
The NPPES record for Pelham Supportive Services was last updated on May 19, 2008. 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.
# Pelham Group Home #2 · NPI 1710144738
Community Based Residential Treatment Facility, Mental Illness organization in Fayetteville, North Carolina. Organization record, active in the CMS NPPES registry since May 19, 2008.
## Identity
- **NPI:** 1710144738 (Entity type: Organization)
- **Enumerated:** May 19, 2008
- **Primary specialty:** Community Based Residential Treatment Facility, Mental Illness · taxonomy 320800000X
- **Legal business name:** Pelham Supportive Services
- **Organization subpart:** No
- **Authorized official:** Mildred Wilson, DIRECTOR
## Practice location
- **Address:** 4906 REDWOOD DR, Fayetteville, NC 28304-4213
- **Phone:** (910) 826-2990
## Record status
- **NPPES last updated:** May 19, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1710144738) · Data from the CMS NPPES public registry.