Organization
THE JANICE MAE HAWKINS FOUNDATION INC
Active
Parent organization
S & S SPOONRIDGE GROUP HOME
Other names
S & S Spoonridge Group Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
S & S SPOONRIDGE GROUP HOME
Authorized official
MS. SHERYL ANNETTE LYONS RN BSN (ADMINISTRATOR CEO)
(910) 864-3426
Entity
Organization
Contact information
Practice address
723 GLEN REILLY DR, FAYETTEVILLE, NC 28314-5600
(910) 864-3426
(910) 491-6803
Mailing address
3359 GABLES DRIVE, FAYETTEVILLE, NC 28301
(910) 864-3426
(910) 491-6803
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL026809
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL026809
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409680
—
NC
Enumeration date
07/10/2008
Last updated
04/17/2014
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