CUMBERLAND CO. HOSPITAL SYSTEM INC (NPI# 1720384423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720384423 |
| Entity Type | Organization |
| Organization Name | CUMBERLAND CO. HOSPITAL SYSTEM INC |
| Other Organization Name | ROXIE AVENUE CENTER |
| Practice Address |
1724 Roxie Ave Fayetteville NC 28304-1623 |
| Practice Telephone | 9106153370 |
| Practice Fax Number | 9106157967 |
| Mailing Telephone | 9106153370 |
| Mailing Fax Number | 9106157967 |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2011-01-28 |
| Authorized Official Name | MR. MICHAEL NAGOWSKI (CEO) |
| Authorized Official Telephone | 9106156700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 273R00000X | Psychiatric Unit | MHL026914 | NC | Hospital Units |
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | MHL026914 | NC | Hospital Units |
| Other Name | Type Code |
|---|---|
| Roxie Avenue Center | Doing Business As Name - Organization |
| Street Address |
1724 ROXIE AVE |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184694481 | Aaron Avrum Brodsky | Psychologist | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2006-01-26 |
| 1063041259 | Leon Kentrelle Williams | Social Worker | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2020-04-08 |
| 1801451216 | Recovery Innovations, Inc | Community/Behavioral Health | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2019-05-01 |
| 1720441165 | Richard Watson | Social Worker | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2016-04-02 |
| 1336558501 | Oretha Harris | Counselor | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2014-08-12 |
| 1851702856 | Eddrena C Wiggins | Social Worker | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2014-05-13 |
| 1124443163 | Diana Wilma Avila | Counselor | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2014-02-27 |
| 1740537638 | Elizabeth Rae Bakisae Albright | Physician Assistant | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2012-08-09 |
| 1750412516 | County of Cumberland | Psychiatry & Neurology | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2007-03-07 |
| 1811036205 | Anthony Wayne Cannon | Psychologist | 1724 Roxie Ave, Fayetteville, NC 28304-1623 | 2007-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639137565 | Texarkana Behavioral Associates, L.c. | Rehabilitation, Substance Use Disorder Unit | 4253 N. Crossover Rd., Fayetteville, AR 72703 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841676533 | Unc Wakebrook | Rehabilitation, Substance Use Disorder Unit | 107 Sunnybrook Rd, Raleigh, NC 27610-1827 | 2015-08-04 |
| 1073634879 | Frye Regional Medical Center | Rehabilitation, Substance Use Disorder Unit | 2850 Tate Blvd Se, Hickory, NC 28602-1450 | 2007-04-02 |
| 1891754412 | Asheville Veteran Medical Center | Rehabilitation, Substance Use Disorder Unit | 1100 Tunnel Rd, Asheville, NC 28805-2043 | 2006-03-22 |
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on CUMBERLAND CO. HOSPITAL SYSTEM INC.
| 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.