| Impact Carolina Services,inc | |
|
1006 Union Road Suite B Gastonia NC 28054-0000 | |
| (704) 864-8775 | |
| (980) 225-0549 |
| Full Name | Impact Carolina Services,inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1006 Union Road, Gastonia, North Carolina |
| Authorized Official Name and Position | Joseph Adedokun (DIRECTOR) |
| Authorized Official Contact | 7047322006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Carolina Services,inc 106 Doctors Park Suite B Boger City NC 28092-0000 Ph: (704) 732-2006 | Impact Carolina Services,inc 1006 Union Road Suite B Gastonia NC 28054-0000 Ph: (704) 864-8775 |
| NPI Number | 1780135681 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 10/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780135681 | NPI | - | NPPES |
| 5918094 | Medicaid | NC | |
| 6008555 | Medicaid | NC |
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