Fairmont Homes LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

FAIRMONT HOMES LLC

Practice address

2105 Gresham Lake Rd
Raleigh, NC 27615-4204

Phone

(919) 522-9896

NPI assigned

Jan 25, 2011

Organization subpart

No

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

Authorized official

Name

Garrett Watkins

Title

Owner

Phone

(919) 522-9896

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1952606717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 LOUISBURG RD",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276164302",
            "telephone_number": "919-522-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 GRESHAM LAKE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276154204",
            "telephone_number": "919-522-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMONT HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-522-9896"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy L Faircloth, PT
• Fairhavens Counseling and Community Services
• Heather Fairley, LCSW
• Sharon Denice Fairley, MS, LCMHC
• Sydnee Janelle Fairley
• Arizona Danielle Faison, LICENSE #: 16416
• Crystal Faison
• Destiny Alexandria Faison
• Jessica Danyelle Faison, LMFTA
• Joshua Faison

• Adult Care Home Facility in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.