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General NPI Number Information
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NPI Number | 1619767787
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Entity Type | Organization
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Legal Business Name | HEAVENLY AURA FCH LLC
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Dates
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Enumeration Date | 05/10/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 2712 MORGANTON RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-4951
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Country | US
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Telephone | 910-705-1743
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Fax |
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Provider Business Mailing Address
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Address Line | 2712 MORGANTON RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-4951
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Country | US
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Telephone | 910-705-1743
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | MRS. HARMONEE THOMPSON BRELAND
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Credential | BSN, RN
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Telephone | 910-474-3174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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