FAIRLEY SUPPORT GROUP HOME INC. – NPI #1710170238
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

FAIRLEY SUPPORT GROUP HOME INC. is a residential treatment facility located in MAXTON, NC. NPPES has assigned the NPI number 1710170238 to FAIRLEY SUPPORT GROUP HOME INC. on August 20, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320600000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FAIRLEY SUPPORT GROUP HOME INC. below.

NPI Profile for
FAIRLEY SUPPORT GROUP HOME INC.

NPI Number
1710170238
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
FAIRLEY SUPPORT GROUP HOME INC.
Primary location
12519 US HWY 501 SOUTH
MAXTON, NC 28364
Phone: (910) 844-1880 Fax: (910) 844-1880
Mailing address
PO BOX 182
12519 US HWY 501 SOUTH
MAXTON, NC 28364-0182
Phone: (910) 844-1880 Fax: (910) 844-1880
Organization Subpart
No
Authorized Official
TONY FAIRLEY
ADMINISTRATOR/CEO
Phone: (910) 844-1880
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320600000X
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
NC MHL-078-174

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.