NPIMap

Organization Active NPI

Cornerstone Treatment Facility, Inc.

  • Psychiatric Residential Treatment Facility
  • Raeford, NC
National Provider Identifier
1003141912
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
CORNERSTONE TREATMENT FACILITY, INC.
Practice address
1958 Turnpike Road
Raeford, NC 28376-8520
Phone
(910) 904-7180
Fax
(910) 904-7177
NPI assigned
Oct 9, 2009
Last updated
Mar 14, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Frederick Surgeon
Title
Ceo
Phone
(910) 733-0617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X NU Primary

Addresses

Primary practice location

1958 Turnpike Road
Raeford, NC 28376-8520

Mailing address

733 Bargain St
Fayetteville, NC 28303-3494
Phone (850) 512-9166

Other identifiers 1

IdentifierTypeStateIssuer
3404565MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003141912. Details of each certification follow.

  • CCN 34L019 Psychiatric residential treatment facility · Active · Name & address match · Details

Psychiatric residential treatment facility certification: CCN 34L019

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HOPE GARDENS TREATMENT CENTER
Certification status
Active
Provider type (POS)
Psychiatric residential treatment facility
Participating since
Dec 10, 2015
Last certification
Dec 10, 2015
Beds
12
Ownership / control type
Non-profit – corporation
Facility address
1958 Turnpike Road
Raeford, NC 28376

National Provider Directory

National Provider Directory
Tax ID family
Cornerstone Treatment Facility Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

733 Bargain St
Fayetteville, NC 28303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1003141912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 BARGAIN ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033494",
            "telephone_number": "850-512-9166",
            "fax_number": "877-472-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 TURNPIKE ROAD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283768520",
            "telephone_number": "910-904-7180",
            "fax_number": "910-904-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE TREATMENT FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-09",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "SURGEON",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-733-0617",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404565",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.