| Gaston Residential Services, Inc. | |
|
905a N New Hope Rd Gastonia NC 28054-3354 | |
| (704) 861-9280 | |
| (704) 868-2154 |
| Full Name | Gaston Residential Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 905a N New Hope Rd, Gastonia, North Carolina |
| Authorized Official Name and Position | Thomas G Davis (FINANCE DIRECTOR) |
| Authorized Official Contact | 7048619280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaston Residential Services, Inc. 905a N New Hope Rd Gastonia NC 28054-3354 Ph: (704) 861-9280 | Gaston Residential Services, Inc. 905a N New Hope Rd Gastonia NC 28054-3354 Ph: (704) 861-9280 |
| NPI Number | 1558425884 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 09/13/2021 |
| Certification Date | 09/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558425884 | NPI | - | NPPES |
| MHL-036-239 | Other | NC | FAIRVIEW GROUP HOME LICENSE |
| 8300506 | Medicaid | NC | |
| 7802582 | Medicaid | NC | |
| 7804622 | Medicaid | NC | |
| 3408863 | Medicaid | NC | |
| 7802105 | Medicaid | NC | |
| 7802058 | Medicaid | NC |
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