Organization
FOREVER YOUNG GROUP CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALMA JEAN WESTON BA (OWNER)
(910) 527-0258
Entity
Organization
Contact information
Practice address
975 COMET CIR, FAYETTEVILLE, NC 28314-0400
(910) 527-0258
(910) 864-2548
Mailing address
1133 CHESTNUT WOOD DR, FAYETTEVILLE, NC 28314-1890
(910) 527-0258
(910) 864-2548
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL026678
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603934
—
NC
Enumeration date
02/01/2007
Last updated
04/08/2013
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