Organization
PELHAM SUPPORTIVE SERVICES
Active
Other names
PELHAM GROUP HOME #2
Organization subpart
No
Provider details
NPI number
Authorized official
MILDRED WILSON (DIRECTOR)
(910) 630-6757
Entity
Organization
Contact information
Practice address
4906 REDWOOD DR, FAYETTEVILLE, NC 28304-4213
(910) 826-2990
Mailing address
949 COUNTRY CLUB DR, FAYETTEVILLE, NC 28301-2907
(910) 630-6757
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-026-824
NC
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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