Fayetteville Manor, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-026-054 Issued in NC

Legal business name

FAYETTEVILLE MANOR, LLC

Practice address

231 Treetop Dr
Fayetteville, NC 28311-0606

Phone

(910) 488-4821

Fax

(910) 488-5069

NPI assigned

Feb 23, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Thomas Husvar

Title

Member

Phone

(704) 608-0761

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1255571766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9895",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119093",
            "telephone_number": "910-488-4821",
            "fax_number": "910-488-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 TREETOP DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283110606",
            "telephone_number": "910-488-4821",
            "fax_number": "910-488-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "HUSVAR",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "704-608-0761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-026-054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.