MEDICARE: FIRST PRIORITY HOMES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	MHL-026-815	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3418255	OTHER	NC	PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558425850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST PRIORITY HOMES, INC.

Provider Business Mailing Address
First Line	:	7779 PINTAIL DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-7405
Country	:	US
Telephone Number	:	910-630-2554
Fax Number	:	910-630-2554

Provider Business Practice Location Address
First Line	:	1419 MILTON ST
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-2511
Country	:	US
Telephone Number	:	910-339-0902
Fax Number	:	910-339-0902

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD DAVIS III
Credential	:
Telephone Number	:	910-797-8825

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	06/18/2008

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