| Enterpro Stc Services | |
|
1554 Union Rd Ste B Gastonia NC 28054-5581 | |
| (704) 852-3053 | |
| (704) 852-3756 |
| Full Name | Enterpro Stc Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1554 Union Rd Ste B, Gastonia, North Carolina |
| Authorized Official Name and Position | Shanda G Knox (PRESIDENT) |
| Authorized Official Contact | 7048523053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enterpro Stc Services 1554 Union Rd Ste B Gastonia NC 28054-5581 Ph: (704) 852-3053 | Enterpro Stc Services 1554 Union Rd Ste B Gastonia NC 28054-5581 Ph: (704) 852-3053 |
| NPI Number | 1750517025 |
|---|---|
| Provider Enumeration Date | 06/01/2009 |
| Last Update Date | 06/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750517025 | NPI | - | NPPES |
| 6006204 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C001183 (North Carolina) | Primary |
| 253Z00000X | In Home Supportive Care | C001183 (North Carolina) | Secondary |
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