=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134325509
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEWARD GROUP OF LOVE RESIDENTIAL FACILITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 NELSON AVE
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28314-2053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-826-0900
-----------------------------------------------------
Fax | 910-826-0901
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 NELSON AVE
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28314-2053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-826-0900
-----------------------------------------------------
Fax | 910-826-0901
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MRS. EUNICE MAE STEWARD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 910-884-7794
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320800000X
-----------------------------------------------------
Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
-----------------------------------------------------
License Number | MHL-026-836
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 320900000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
-----------------------------------------------------
License Number | MHL-026-836
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------