| Broken Pieces Services Llc | |
|
2020 Remount Rd Gastonia NC 28054-7476 | |
| (980) 355-3737 | |
| Not Available |
| Full Name | Broken Pieces Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2020 Remount Rd, Gastonia, North Carolina |
| Authorized Official Name and Position | Marquita Russell (OPERATIONS) |
| Authorized Official Contact | 9802589315 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broken Pieces Services Llc 2020 Remount Rd Ste G-100b Gastonia NC 28054-7476 Ph: (980) 355-3737 | Broken Pieces Services Llc 2020 Remount Rd Gastonia NC 28054-7476 Ph: (980) 355-3737 |
| NPI Number | 1265959100 |
|---|---|
| Provider Enumeration Date | 08/22/2017 |
| Last Update Date | 08/15/2023 |
| Certification Date | 08/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265959100 | NPI | - | NPPES |
| 00571688 | Medicaid | NC | |
| GP7951 | Medicaid | SC |
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