| Impact Carolina Services | |
|
1552 Union Rd Suite C Gastonia NC 28054-5523 | |
| (704) 852-9210 | |
| (704) 852-9211 |
| Full Name | Impact Carolina Services |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1552 Union Rd, Gastonia, North Carolina |
| Authorized Official Name and Position | Joseph Adedokun (CEO) |
| Authorized Official Contact | 7047322006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Carolina Services 1552 Union Rd Suite C Gastonia NC 28054-5523 Ph: (704) 852-9210 | Impact Carolina Services 1552 Union Rd Suite C Gastonia NC 28054-5523 Ph: (704) 852-9210 |
| NPI Number | 1629311063 |
|---|---|
| Provider Enumeration Date | 04/04/2013 |
| Last Update Date | 04/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629311063 | NPI | - | NPPES |
| 5004910 | Medicaid | NC | |
| 6003129 | Medicaid | NC | |
| 891036Y | Medicaid | NC | |
| 5004878 | Medicaid | NC | |
| 6111767 | Medicaid | NC |
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