| S & S Spoonridge | |
|
3359 Gables Dr. Fayetteville NC 28301 | |
| (910) 864-3426 | |
| (910) 764-1457 |
| Full Name | S & S Spoonridge |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3359 Gables Dr., Fayetteville, North Carolina |
| Authorized Official Name and Position | Sheryl Annette Lyons (CEO ADMINISTRATOR) |
| Authorized Official Contact | 9108643426 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S & S Spoonridge 3359 Gables Dr. Fayetteville NC 28301-0340 Ph: (910) 864-3426 | S & S Spoonridge 3359 Gables Dr. Fayetteville NC 28301 Ph: (910) 864-3426 |
| NPI Number | 1982735239 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 04/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982735239 | NPI | - | NPPES |
| 3409680 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-026-809 (North Carolina) | Primary |
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