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432 E Long Ave Ste 2 Gastonia NC 28054-2540 | |
| (980) 416-3025 | |
| (980) 448-3419 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 432 E Long Ave Ste 2, Gastonia, North Carolina |
| Authorized Official Name and Position | Benny Locklear (CEO) |
| Authorized Official Contact | 9109640678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
432 East Long Avenue Suite 2 Gastonia NC 28054-2540 Ph: (980) 416-3025 | 432 E Long Ave Ste 2 Gastonia NC 28054-2540 Ph: (980) 416-3025 |
| NPI Number | 1639806359 |
|---|---|
| Provider Enumeration Date | 08/03/2022 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/25/2024 |
| Medicare PECOS PAC ID | 3274079082 |
|---|---|
| Medicare Enrollment ID | O20240729000480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639806359 | NPI | - | NPPES |
| 1467162065 | Medicaid | NC | |
| 1639806359 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Claude Naar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225277296 PECOS PAC ID: 4082892427 Enrollment ID: I20200904001245 |
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