| Nc Mentor | |
|
1209 E. Garrison Blvd Gastonia NC 28054-5115 | |
| (704) 864-6573 | |
| (704) 864-9791 |
| Full Name | Nc Mentor |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1209 E. Garrison Blvd, Gastonia, North Carolina |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nc Mentor 313 Congress St Boston MA 02210-1218 Ph: (800) 388-5150 | Nc Mentor 1209 E. Garrison Blvd Gastonia NC 28054-5115 Ph: (704) 864-6573 |
| NPI Number | 1760522858 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 03/19/2023 |
| Certification Date | 03/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760522858 | NPI | - | NPPES |
| 8300358 | Medicaid | NC |
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