Pelham Supportive Services
NPI 1053626135 · Mental Illness Community Based Residential Treatment Facility · Fayetteville, NC
Pelham Supportive Services is a Mental Illness Community Based Residential Treatment Facility organization in Fayetteville, NC (NPI 1053626135).
Provider details
- NPI number
- 1053626135
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Mildred Wilson, Owner(910) 630-6757
- License
- MHL-2620 (NC)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Pelham Group Home #4
Registry dates
- Enumerated
- 2010-08-12
- Last updated
- 2010-08-12
Frequently asked questions
- What is Pelham Supportive Services's NPI number?
- Pelham Supportive Services's National Provider Identifier (NPI) is 1053626135, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pelham Supportive Services?
- Pelham Supportive Services is classified in the NPPES registry as Mental Illness Community Based Residential Treatment Facility (Residential Treatment Facilities).
- Where is Pelham Supportive Services located?
- Pelham Supportive Services's practice location on file with NPPES is 2226 Memory St, Fayetteville, NC 28304-5827.
- What is Pelham Supportive Services's phone number?
- The practice phone number listed in the NPPES registry for Pelham Supportive Services is (910) 429-0081.
- Who is the authorized official for Pelham Supportive Services?
- The authorized official listed on Pelham Supportive Services's NPPES record is Mildred Wilson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pelham Supportive Services's NPI active?
- Yes — Pelham Supportive Services's NPI (1053626135) is active in the NPPES registry as of the last update on 2010-08-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.