Organization
FAIRMONT HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRETT WATKINS (OWNER)
(919) 522-9896
Entity
Organization
Contact information
Practice address
2105 GRESHAM LAKE RD, RALEIGH, NC 27615-4204
(919) 522-9896
Mailing address
4428 LOUISBURG RD, SUITE 105, RALEIGH, NC 27616-4302
(919) 522-9896
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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