Organization
MID-STATE HEALTH SYSTEMS, INC
Active
Other names
My Place
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SERA GILMORE (ADMINISTRATOR)
(910) 484-3717
Entity
Organization
Contact information
Practice address
1050 HOGAN ST, FAYETTEVILLE, NC 28311-2340
(910) 484-3717
(910) 484-1315
Mailing address
3721 LEGION RD, HOPE MILLS, NC 28348-8411
(910) 484-3717
(910) 484-1315
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-026-943
NC
Other
Enumeration date
07/23/2013
Last updated
12/07/2015
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