CARILLON ASSISTED LIVING OF FAYETTEVILLE, LLC (NPI# 1871723791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871723791 |
| Entity Type | Organization |
| Organization Name | CARILLON ASSISTED LIVING OF FAYETTEVILLE, LLC |
| Other Organization Name | CARILLON ASSISTED LIVING OF FAYETTEVILLE |
| Practice Address |
1164 71st School Rd Fayetteville NC 28314-2817 |
| Mailing Address |
4901 Waters Edge Dr Suite 200 Raleigh NC 27606-2464 |
| Practice Telephone | 9198524000 |
| Practice Fax Number | 9198524001 |
| Mailing Telephone | 9198524000 |
| Mailing Fax Number | 9198524001 |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2009-07-27 |
| Authorized Official Name | MR. KEVIN MARK JOHNSON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9198524000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Carillon Assisted Living of Fayetteville | Doing Business As Name - Organization |
| Street Address |
1164 71ST SCHOOL RD |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28314-2817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316584782 | Ga Hc Reit II Fayetteville Alf Trs Sub, LLC | Custodial Care Facility | 1164 71st School Rd, Fayetteville, NC 28314-2817 | 2019-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528677812 | Lamonica Laveta Greene | Massage Therapist | 7804 Loxley Drive, Fayetteville, NC 28314 | 2020-07-23 |
| 1467086496 | The Pair Center for Couples Counseling Pllc | Counselor | 5085 Morganton Road, Suite 300, Fayetteville, NC 28314 | 2020-02-28 |
| 1346898335 | Chaitanya Joopally Dds Pllc | Dentist | 2050 Skibo Rd. Ste 104, Fayetteville, NC 28314 | 2019-09-03 |
| 1780231894 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 2360 Williamwood Lane, Fayetteville, NC 28314 | 2019-08-22 |
| 1164075982 | A Touch of Grace Inc | Day Training/Habilitation Specialist | 2153 Heathcote Drive, Fayetteville, NC 28314 | 2019-07-21 |
| 1093284465 | Candice Gorremans | Physician Assistant | 108th Air Defense Artillery Brigade, Fort Bragg, NC 28314 | 2018-11-15 |
| 1861983439 | Jessica Lynne Smith | Counselor | 6885 Cliffdale Rd Ste 2002, Fayetteville, NC 28314 | 2018-05-19 |
| 1073003752 | Gooden Mobile Pod Nc Pllc | Podiatrist | 311 Mcfadyen Dr, Fayetteville, NC 28314 | 2018-05-17 |
| 1093222101 | Lauren Bonneau | Behavioral Analyst | 6985 Nexus Ct, Suite 107, Fayetteville, NC 28314 | 2018-01-10 |
| 1760900153 | Elali Alisha Marie Moukwa | Dentist | 1916 Skibo Rd Ste C3, Fayetteville, NC 28314 | 2017-09-06 |
| Find all providers in zip 28314 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306383450 | Family First Operating, LLC | Assisted Living Facility | 113 Medical Center Blvd, Fayetteville, TN 37334-2685 | 2017-01-27 |
| 1235494246 | Phenix Enterprise Services, LLC | Assisted Living Facility | 180 Championship Ct, Fayetteville, GA 30215-8017 | 2012-07-06 |
| 1619274644 | Southern Manor Living Centers, LLC | Assisted Living Facility | 115 Medical Center Blvd, Fayetteville, TN 37334-2689 | 2011-02-28 |
| 1750517496 | Miracle Restoration | Assisted Living Facility | 4850 Old Savannah Church Rd, Fayetteville, NC 28312-9183 | 2009-06-09 |
| 1770737504 | Lauren & Londen, Inc. | Assisted Living Facility | 610 Mann St, Fayetteville, NC 28301-6240 | 2008-11-06 |
| 1003079872 | Valley Pines Adult Care | Assisted Living Facility | 2521 Muriel Dr, Fayetteville, NC 28306-3213 | 2008-07-02 |
| 1740466937 | Magnolia Lane LLC | Assisted Living Facility | 3510 Camden Rd, Fayetteville, NC 28306-7717 | 2008-01-17 |
| 1528189917 | Cedar Creek Assisted Living, LLC | Assisted Living Facility | 1124 Cedar Creek Rd, Fayetteville, NC 28312-6544 | 2007-04-03 |
| 1346370459 | Peterkin & Associates, Inc. | Assisted Living Facility | 7559 Decatur Dr, Fayetteville, NC 28303-1989 | 2007-03-07 |
| 1841320330 | Hope Rest Home, Inc. | Assisted Living Facility | 2967 Dunn Rd, Fayetteville, NC 28312-8883 | 2007-03-06 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28314 |
Please comment or provide details below to improve the information on CARILLON ASSISTED LIVING OF FAYETTEVILLE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.