| 612 Behavioral And Community Services | |
|
2559 Quail Ridge Dr Gastonia NC 28056-9205 | |
| (704) 674-5455 | |
| Not Available |
| Full Name | 612 Behavioral And Community Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2559 Quail Ridge Dr, Gastonia, North Carolina |
| Authorized Official Name and Position | Demise Lamaar Williams (CEO) |
| Authorized Official Contact | 7046745455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 612 Behavioral And Community Services 2559 Quail Ridge Dr Gastonia NC 28056-9205 Ph: (704) 674-5455 | 612 Behavioral And Community Services 2559 Quail Ridge Dr Gastonia NC 28056-9205 Ph: (704) 674-5455 |
| NPI Number | 1336333129 |
|---|---|
| Provider Enumeration Date | 09/05/2007 |
| Last Update Date | 09/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336333129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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