Fairley Support Group Home Inc.
NPI #1710170238 in Maxton, North Carolina
Provider Information
- NPI Number
- 1710170238
- Entity Type
- Organization
- Organization Name
- Fairley Support Group Home Inc.
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Aug 20, 2007
- Last Updated
- Aug 20, 2007
Practice Location
- Address
- 12519 US HWY 501 SOUTH
- City
- Maxton
- State
- North Carolina
- ZIP Code
- 28364
- Phone
- (910) 844-1880
Authorized Official
- Name
- MR. TONY MELVIN FAIRLEY
- Title
- ADMINISTRATOR/CEO
- Phone
- (910) 844-1880
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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