# GRACELAND MANOR & ASSOCIATES, INC

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

## Provider details

- **NPI number:** 1821124116
- **Authorized official:** ELVA COLVIN (CEO)
- **Authorized official phone:** (910) 488-8807

## Contact information

- **Practice address:** 408 PELT DR, FAYETTEVILLE, NC 28301-3412
- **Practice address phone:** (910) 322-6855
- **Mailing address:** PO BOX 35174, FAYETTEVILLE, NC 28303-0174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL 026 654 | NC | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL 026 655 | NC | — |
| 320700000X | Physical Disabilities Residential Treatment Facility | FCL 026 026 | NC | Yes |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 07/01/2010