# AUTUMN CARE OF FAYETTEVILLE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AUTUMN CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114463932
- **Legal business name:** AUTUMN CORPORATION
- **Authorized official:** WILLIAM I WEISBERG (PRESIDENT)
- **Authorized official phone:** (216) 292-5706

## Contact information

- **Practice address:** 1401 71ST SCHOOL RD, FAYETTEVILLE, NC 28314-2814
- **Practice address phone:** (910) 867-4960
- **Practice address fax:** (910) 867-4980
- **Mailing address:** 23700 COMMERCE PARK, BEACHWOOD, OH 44122-5827
- **Mailing address phone:** (216) 292-5706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/18/2017
- **Last updated:** 01/10/2022