MID-STATE HEALTH SYSTEMS, INC


Address: 7559 Decatur Dr, Fayetteville, NC 28303-1989
Phone: 9104843717

MID-STATE HEALTH SYSTEMS, INC (NPI# 1083056782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083056782
Entity Type Organization
Organization Name MID-STATE HEALTH SYSTEMS, INC
Other Organization Name THOMAS S DECATUR HOME
Practice Address 7559 Decatur Dr
Fayetteville
NC 28303-1989
Mailing Address 3721 Legion Rd
Hope Mills
NC 28348-8411
Practice Telephone 9104843717
Practice Fax Number 9104841315
Mailing Telephone 9104843717
Mailing Fax Number 9104841315
Enumeration Date 2013-07-23
Last Update Date 2015-12-07
Authorized Official Name SERA GILMORE (ADMINISTRATOR)
Authorized Official Telephone 9104843717
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 315P00000X Intermediate Care Facility, Mentally Retarded MHL-026-944 NC Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
Thomas S Decatur Home Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1851609085 Mid-state Health Systems, Inc Clinic/Center 2908 Reynolda Rd, Winston Salem, NC 27106-3016 2010-09-22
1679762066 Mid-state Health Systems, Inc Community/Behavioral Health 117 Beasley St, 2nd Floor, Kenansville, NC 28349 2007-10-22
1114005261 Mid-state Health Systems, Inc Community/Behavioral Health 3721 Legion Rd, Hope Mills, NC 28348-8411 2006-11-02
1477634319 Mid-state Health Systems, Inc Intermediate Care Facility, Mentally Retarded 4309 N.c. Hwy 87 S, Fayetteville, NC 28306-9818 2006-10-18
1023450723 Mid-state Health Systems, Inc Intermediate Care Facility, Mentally Retarded 1050 Hogan St, Fayetteville, NC 28311-2340 2013-07-23
1477865541 Mid-state Health Systems, Inc Clinic/Center 3721 Legion Rd, Hope Mills, NC 28348-8411 2010-07-06
1114168374 Mid-state Health Systems, Inc Community/Behavioral Health 3721 Legion Rd, Hope Mills, NC 28348-8411 2009-03-18
1992865851 Mid-state Health Systems, Inc Case Management 3721 Legion Rd, Hope Mills, NC 28348-8411 2006-12-11

Office Location

Street Address 7559 DECATUR DR
City FAYETTEVILLE
State NC
Zip Code 28303-1989

Providers in the same location

NPI Name Taxonomy Address Enumeration
1346370459 Peterkin & Associates, Inc. Assisted Living Facility 7559 Decatur Dr, Fayetteville, NC 28303-1989 2007-03-07

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801404496 Matthew Pace Physician Assistant Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 2020-07-20
1952920449 Vonetta Bethea Jackson Social Worker 391 Wagoner Drive, Fayetteville, NC 28303 2020-04-14
1932746229 Julie Harriss Specialist/Technologist Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 2019-12-05
1235780354 Helen Delores Johnson Technician 261 Pierron Dr, Fayetteville, NC 28303 2019-09-20
1922655075 Andrea Margaret Hutnam Technician 714 Shortridge Rd, Fayetteville, NC 28303 2019-08-23
1225695273 Breona Lister Dental Hygienist 38 17 Gruber Rd, Fort Bragg, NC 28303 2019-05-24
1780148957 Brian K Cox Sr. Occupational Therapy Assistant 5300 Ramsey St, Fayetteville, NC 28303 2019-01-22
1730670902 Michael Sadtler Counselor 804 Stamper Rd Ste 101, Fayetteville, NC 28303 2018-05-23
1104320399 Tia Porterfield Counselor 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 2018-03-21
1154835577 Jessica Bass Bosworth Psychologist 3415 Youngstown Dr, Fayetteville, NC 28303 2017-11-21
Find all providers in zip 28303

Taxonomy Information

Taxonomy Code 315P00000X
Grouping Nursing & Custodial Care Facilities
Classification Intermediate Care Facility, Mentally Retarded

Taxonomy Definition

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609299916 Rha Health Services Nc, LLC Intermediate Care Facility, Mentally Retarded 1802 Strickland Bridge Rd, Fayetteville, NC 28304-5739 2014-01-23
1255574034 Greater Image Healthcare, Corp Intermediate Care Facility, Mentally Retarded 401 Roberson Street, Fayetteville, NC 28301-5423 2009-04-09
1487799151 Rha Health Services Nc, LLC Intermediate Care Facility, Mentally Retarded 2001 Southern Ave, Fayetteville, NC 28306-1757 2007-02-21
1467597708 Rha Health Services Nc, LLC Intermediate Care Facility, Mentally Retarded 1818 Strickland Bridge Rd, Fayetteville, NC 28304-5739 2007-02-21
1912042797 Rha Health Services Nc, LLC Intermediate Care Facility, Mentally Retarded 800 Old Wilmington Rd, Fayetteville, NC 28301-6210 2007-02-20
1740337757 Davis & Associates, Inc Intermediate Care Facility, Mentally Retarded 1108 Quailmeadow Dr, Fayetteville, NC 28314-5936 2007-01-04
1699850891 Sophia B Pierce & Associates Inc Intermediate Care Facility, Mentally Retarded 3301 Barksdale Road, Fayetteville, NC 28301 2006-10-26
1477634319 Mid-state Health Systems, Inc Intermediate Care Facility, Mentally Retarded 4309 N.c. Hwy 87 S, Fayetteville, NC 28306-9818 2006-10-18
1023450723 Mid-state Health Systems, Inc Intermediate Care Facility, Mentally Retarded 1050 Hogan St, Fayetteville, NC 28311-2340 2013-07-23
1922266816 D & L Healthcare Services Intermediate Care Facility, Mentally Retarded 1108 Quailmeadow Dr, Fayetteville, NC 28314-5936 2008-05-28
Find all providers in FAYETTEVILLE

Competitor

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City FAYETTEVILLE
Zip Code 28303

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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