Provider Demographics
NPI:1972287266
Name:FAYETTE PARTNERS LLC
Entity Type:Organization
Organization Name:FAYETTE PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYBBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-268-2288
Mailing Address - Street 1:105 CARNOUSTIE WAY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-7814
Mailing Address - Country:US
Mailing Address - Phone:770-268-2288
Mailing Address - Fax:
Practice Address - Street 1:14 EASTBROOK BND STE 100
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1519
Practice Address - Country:US
Practice Address - Phone:770-268-2288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care