DFM Incorportated Adolescent Home

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL-047-112 Issued in NC

Legal business name

DFM INCORPORTATED ADOLESCENT HOME

Practice address

3999 Fayetteville Rd
Raeford, NC 28376-8059

Phone

(910) 273-5473

Fax

(919) 498-0874

NPI assigned

Apr 1, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Tiffany Delorse Monroe, BS

Title

Ceo

Phone

(910) 273-5473

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1871735233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7735 S SHIELD DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283146352",
            "telephone_number": "910-273-5473",
            "fax_number": "919-498-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 FAYETTEVILLE RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283768059",
            "telephone_number": "910-273-5473",
            "fax_number": "919-498-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DFM INCORPORTATED ADOLESCENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "DELORSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-273-5473",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-047-112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Raeford, NC
• Providers in Raeford, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.