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COLLEGE LAKES
NPI 1841612215
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Fayetteville, NC

Active since January 20, 2014
5104 FLATROCK DRIVE, FAYETTEVILLE, NC 28311(910) 488-6323(910) 223-2180 Get Directions Write a Review

NPPES record last updated: April 21, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 21, 2021, Mar 24, 2021 (2 updates tracked since 2021).

About College Lakes NPPES

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

COLLEGE LAKES (NPI 1841612215) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Fayetteville, North Carolina and active in the NPI registry since January 2014. The organization lists Nikki Giovanni Creecy, Ceo, as its authorized official.

NPPES Registry Identity

NPI1841612215
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameCOLLEGE LAKES
Location Address5104 FLATROCK DRIVEFayetteville, NC 28311
Mailing Address5104 Flatrock DriveFayetteville, NC 28311 · (910) 257-6406
Phone(910) 488-6323
Fax(910) 223-2180
Organization SubpartYesParent: Shinelight, Inc.
Authorized OfficialNikki Giovanni CreecyCeo · (910) 257-6406
Enumeration DateJanuary 20, 2014
Last NPPES UpdateApril 21, 20212 updates tracked since enumeration
NPPES CertifiedApril 21, 2021
✔ NPI 1841612215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
License✔ Licensed in NC · MHL-047-133
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
5104 FLATROCK DRIVE, Fayetteville, NC 28311
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Other Identifiers 1

Medicaid3418071NC

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 College Lakes's NPI number?

The NPI number for College Lakes is 1841612215. It was assigned to this organization in the NPPES registry on January 20, 2014.

Where is College Lakes located?

College Lakes is located at 5104 Flatrock Drive, Fayetteville, NC 28311. The listed phone number is (910) 488-6323.

What is College Lakes's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for College Lakes was last updated on April 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.