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NPI 1548309511 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Fayetteville, NC
Provider details
- NPI number
- 1548309511
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Annie Williams, Owner(910) 630-2374
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Agencies
- Community/Behavioral Health Agency251S00000X
Agencies
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
1918 Blake St
Fayetteville, NC 28301-4117
Phone: (910) 630-2374
Fax: (910) 764-0404
Street-level locationGet directions
Mailing address
Po Box 1692
Fayetteville, NC 28302-1692
Registry dates
- Enumerated
- 2007-02-06
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.