NPIMap

Organization Active NPI

Cornerstone Treatment Facility, Inc.

  • Psychiatric Residential Treatment Facility
  • Wadesboro, NC
National Provider Identifier
1285969279
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
129 Wallace Rd
Wadesboro, NC 28170-2434
Phone
(704) 695-0601
Fax
(704) 695-0607
NPI assigned
Oct 8, 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

129 Wallace Rd
Wadesboro, NC 28170-2434

Mailing address

733 Bargain St
Fayetteville, NC 28303-3494
Phone (877) 472-2302

Other identifiers 1

IdentifierTypeStateIssuer
3404556MedicaidNC

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.

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": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1285969279",
    "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": "877-472-2302",
            "fax_number": "877-472-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 WALLACE RD",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281702434",
            "telephone_number": "704-695-0601",
            "fax_number": "704-695-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE TREATMENT FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "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": "3404556",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.