# GLENN KRYSTLE MANOR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700906070
- **Authorized official:** MS. CYNTHIA DANETTA GARRISON (ADMINISTRATOR/OWNER)
- **Authorized official phone:** (910) 527-4673

## Contact information

- **Practice address:** 220 DAVIS ST, FAYETTEVILLE, NC 28305-5346
- **Practice address phone:** (910) 486-8854
- **Mailing address:** 1887 SPIRALWOOD DR, FAYETTEVILLE, NC 28304-0499
- **Mailing address phone:** (910) 527-4673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL-026-049 | NC | Yes |

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 06/24/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7805650 | — | NC |