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MID-STATE HEALTH SYSTEMS, INC

Intermediate Care Facility, Mentally Retarded

Fayetteville, North Carolina

Provider NPI: 1477634319

Organization Information:
Organization Name:  MID-STATE HEALTH SYSTEMS, INC


Practice Location:
4309 N.C. HWY 87 S  FAYETTEVILLE, NC 28306 US
Tel: 910-484-3717  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
NCMHL-026-054

Other Provider Identifiers:

IssuerNumberStateType
3406591NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS NC - Page 1



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