NPI 1477634319

Mid-State Health Systems, INC

Organisation Intellectual Disabilities Intermediate Care Facility Fayetteville, NC

Practice location

Address: 4309 N.C. Hwy 87 S, Fayetteville, NC 28306-9818
Phone: (910) 484-3717
Fax: (910) 484-1315
Mailing address: 3721 Legion Rd, Hope Mills, NC 28348-8411

Authorised official

Name: Sera W Gilmore
Title: Administrator
Phone: (910) 484-3717

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence MHL-026-054 (NC)

Other Intermediate Care Facility, Intellectual Disabilities providers in North Carolina →

Registry record

NPI: 1477634319
Entity type: Organization
NPI issued: 18 Oct 2006
Record last updated: 15 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.