# DFM INCORPORTATED ADOLESCENT HOME

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

## Provider details

- **NPI number:** 1871735233
- **Authorized official:** MS. TIFFANY DELORSE MONROE BS (CEO)
- **Authorized official phone:** (910) 273-5473

## Contact information

- **Practice address:** 3999 FAYETTEVILLE RD, RAEFORD, NC 28376-8059
- **Practice address phone:** (910) 273-5473
- **Practice address fax:** (919) 498-0874
- **Mailing address:** 7735 S SHIELD DR, FAYETTEVILLE, NC 28314-6352
- **Mailing address phone:** (910) 273-5473
- **Mailing address fax:** (919) 498-0874

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-047-112 | NC | Yes |

## Other

- **Enumeration date:** 04/01/2009
- **Last updated:** 04/01/2009