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PELHAM GROUP HOME #3
NPI 1770924482
Community Based Residential Treatment Facility, Mental Illness in Fayetteville, NC

Active since July 10, 2013
5740 LONGVIEW DR, FAYETTEVILLE, NC 28306(910) 425-4168(910) 488-8823 Get Directions Write a Review

NPPES record last updated: July 11, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pelham Group Home #3 NPPES

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

PELHAM GROUP HOME #3 (NPI 1770924482) 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 July 2013. The organization lists Mildred Wilson, Director, as its authorized official.

NPPES Registry Identity

NPI1770924482
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NamePELHAM SUPPORTIVE SERVICES
Location Address5740 LONGVIEW DRFayetteville, NC 28306-8567
Mailing Address949 Country Club DrFayetteville, NC 28301-2907 · (910) 488-7633
Phone(910) 425-4168
Fax(910) 488-8823
Organization SubpartNo
Authorized OfficialMildred WilsonDirector · (910) 488-7633
Enumeration DateJuly 10, 2013
Last NPPES UpdateJuly 11, 2013
✔ NPI 1770924482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
License✔ Licensed in NC · MHL-026-854
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
5740 LONGVIEW DR, Fayetteville, NC 28306
Open in Google Maps ↗

Other Names 1

Doing Business AsPelham Group Home #3

Other Identifiers 1

Medicaid7806041NC

Other Providers at the Same Location NPPES

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

MACBILL,INC.
Community Based Residential Treatment Facility, Mental Illness
5740 LONGVIEW DR
FAYETTEVILLE, NC 28306
Cumberland County (252) 526-7781

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 1770924482. It was assigned to this organization in the NPPES registry on July 10, 2013. The provider is doing business as Pelham Group Home #3.

Where is Pelham Supportive Services located?

Pelham Supportive Services is located at 5740 Longview Dr, Fayetteville, NC 28306. The listed phone number is (910) 425-4168.

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 July 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.