Graceland Manor & Associates, Inc

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

FCL 026 026 Issued in NC

Legal business name

GRACELAND MANOR & ASSOCIATES, INC

Practice address

408 Pelt Dr
Fayetteville, NC 28301-3412

Phone

(910) 322-6855

NPI assigned

Feb 23, 2007

Last updated

Jul 1, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elva Colvin

Title

Ceo

Phone

(910) 488-8807

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1821124116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35174",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283030174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 PELT DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013412",
            "telephone_number": "910-322-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACELAND MANOR & ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "COLVIN",
        "authorized_official_first_name": "ELVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-488-8807"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL 026 655",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL 026 654",
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NC",
            "license": "FCL 026 026",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Graham Chiropractic & Health
• Emanuel Graham Jr.

• Physical Disabilities Residential Treatment Facility in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physical Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.