Organization
MID-STATE HEALTH SYSTEMS, INC
Active
Other names
No Place Like Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SERA W GILMORE (ADMINISTRATOR)
(910) 484-3717
Entity
Organization
Contact information
Practice address
4309 N.C. HWY 87 S, FAYETTEVILLE, NC 28306-9818
(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-026-054
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406591
—
NC
Enumeration date
10/18/2006
Last updated
12/15/2015
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