Provider Demographics
NPI:1982764825
Name:DOROTHEA DIX HOSPITAL
Entity Type:Organization
Organization Name:DOROTHEA DIX HOSPITAL
Other - Org Name:CENTRAL REGIONAL HOSPITAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIVISION DIRECTOR - DSOHF
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, FACHE
Authorized Official - Phone:919-855-4700
Mailing Address - Street 1:820 S BOYLAN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-2246
Mailing Address - Country:US
Mailing Address - Phone:919-733-5540
Mailing Address - Fax:919-733-0743
Practice Address - Street 1:820 S BOYLAN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-2246
Practice Address - Country:US
Practice Address - Phone:919-733-5540
Practice Address - Fax:919-733-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health