| Gaston Residential Services, Inc. | |
|
905 N New Hope Rd Ste A Gastonia NC 28054-3373 | |
| (704) 861-9280 | |
| (704) 868-2154 |
| Full Name | Gaston Residential Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 905 N New Hope Rd Ste A, Gastonia, North Carolina |
| Authorized Official Name and Position | Lynette Graslie Demperio (FINANCE DIRECTOR/VICE PRESIDENT) |
| Authorized Official Contact | 7048619280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaston Residential Services, Inc. 905 N New Hope Rd Ste A Gastonia NC 28054-3373 Ph: (704) 861-9280 | Gaston Residential Services, Inc. 905 N New Hope Rd Ste A Gastonia NC 28054-3373 Ph: (704) 861-9280 |
| NPI Number | 1235327099 |
|---|---|
| Provider Enumeration Date | 10/05/2007 |
| Last Update Date | 10/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235327099 | NPI | - | NPPES |
| MHL-036-023 | Other | NC | STATE OF NORTH CAROLINA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-036-023 (North Carolina) | Primary |
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