| Mountain Ridge Group Home | |
|
810 King Arthur Dr Gastonia NC 28056-8469 | |
| (704) 824-8941 | |
| Not Available |
| Full Name | Mountain Ridge Group Home |
|---|---|
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
| Location | 810 King Arthur Dr, Gastonia, North Carolina |
| Authorized Official Name and Position | Kirby Nickerson (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7047548228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Ridge Group Home Po Box 2369 Salisbury NC 28145-2369 Ph: (704) 637-2870 | Mountain Ridge Group Home 810 King Arthur Dr Gastonia NC 28056-8469 Ph: (704) 824-8941 |
| NPI Number | 1851447221 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 06/26/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851447221 | NPI | - | NPPES |
| 3416485 | Medicaid | NC |
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