Living Waters Group Home in Fayetteville - Residential Treatment Facility, Emotionally Disturbed Children
Living Waters Group Home - NPI 1447390042
Living Waters Group Home is a Residential Treatment Facility, Emotionally Disturbed Children in Fayetteville, North Carolina. Living Waters Group Home practices all healthcare services and medical treatments related to Residential Treatment Facility, Emotionally Disturbed Children. The NPI Number for Living Waters Group Home is 1447390042. The last update date is 2020-08-22.
Living Waters Group Home's current location address is 1609 Sweetgum Cir, Fayetteville, North Carolina. You can contact this provider via phone number 9108673279. The mailing address for Living Waters Group Home is 1609 Sweetgum Cir, Fayetteville, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Living Waters Group Home |
|---|---|
| Address | 1609 Sweetgum Cir, Fayetteville, North Carolina |
| Phone Number | 9108673279 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | RESIDENTIA |
|---|---|
| Authorized Official Name | Ealy Ann Beverly |
| Telephone Number | 9107176127 |
NPI Number Detail
| NPI Number | 1447390042 |
|---|---|
| Provider Enumeration Date | 2007-02-06 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1609 Sweetgum Cir |
|---|---|
| City | Fayetteville |
| State | North Carolina (NC) |
| Post Code | 283042707 |
| Phone Number | 9108673279 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
|---|---|
| Taxonomy | 322D00000X |
| Licence No | MHL 026-796 |
|
Definition: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6603850 | NC | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Living Waters Group Home by the Centers for Medicare & Medicaid Services?
The Living Waters Group Home has been assigned the NPI (National Provider Identifier) 1447390042 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Living Waters Group Home is located?
The Living Waters Group Home is situated at the following address: 1609 Sweetgum Cir, Fayetteville, NC, 283042707.
What is Living Waters Group Home's specialized field of practice, and what is the corresponding taxonomy classification code?
The Living Waters Group Home's area of specialization is Residential Treatment Facility, Emotionally Disturbed Children, and the corresponding taxonomy code that categorizes this field of practice is 322D00000X.
On what date did the Living Waters Group Home receive its 1447390042 assignment from the Centers for Medicare & Medicaid Services?
The Living Waters Group Home was assigned its 1447390042 by the Centers for Medicare & Medicaid Services on 2007-02-06.
When was the information related to Living Waters Group Home most recently updated or refreshed?
The details pertaining to the Living Waters Group Home, including its address, specialty, and other relevant information, were last updated or refreshed on 2020-08-22.
NPI Number: 1932102142
Address: St. Jude Children's Research Hospital, Memphis, TN