Organization
FAYETTEVILLE MANOR, LLC
Active
Organization
FAYETTEVILLE MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS HUSVAR (MEMBER)
(704) 608-0761
Entity
Organization
Contact information
Practice address
231 TREETOP DR, FAYETTEVILLE, NC 28311-0606
(910) 488-4821
(910) 488-5069
Mailing address
PO BOX 9895, FAYETTEVILLE, NC 28311-9093
(910) 488-4821
(910) 488-5069
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-026-054
NC
Other
Enumeration date
02/23/2009
Last updated
02/23/2009
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