Fayetteville Al Holdings, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-026-061 Issued in NC

Legal business name

FAYETTEVILLE AL HOLDINGS, LLC

Doing business as

Hertiage Suites

Practice address

240 Ann St
Fayetteville, NC 28301-5543

Phone

(910) 323-4925

Fax

(910) 678-8673

NPI assigned

Oct 8, 2012

Organization subpart

No

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

Authorized official

Name

Charles Trefzger

Title

Manager

Phone

(828) 261-7309

Specialties & licenses 1

Addresses

Other names 1

• Hertiage Suites Doing business as

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1689926107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2568",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286032568",
            "telephone_number": "828-261-7304",
            "fax_number": "828-322-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 ANN ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015543",
            "telephone_number": "910-323-4925",
            "fax_number": "910-678-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE AL HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "828-261-7309"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-026-061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hertiage Suites",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 Oct 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.