Organization
CUMBERLAND RESIDENTIAL & EMPLOYMENT SERVICES & TRAINING
Active
Other names
CREST
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAYNE K. PATTERSON (EXECUTIVE DIRECTOR)
(910) 487-3131
Entity
Organization
Contact information
Practice address
250 PRINCE CHARLES DR, FAYETTEVILLE, NC 28311-0834
(910) 487-3131
(910) 487-0637
Mailing address
PO BOX 877, FAYETTEVILLE, NC 28302-0877
(910) 487-3131
(910) 487-0637
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-026-643
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804519
—
NC
Enumeration date
02/16/2007
Last updated
07/11/2012
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