612 Behavioral And Community Services

NPI 1336333129 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1336333129
Enumeration Date 09/05/2007
Last Updated 09/05/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DEMISE LAMAAR DEMISE
Position CEO
Phone (704) 674-5455
Fax
Practice Location
2559 QUAIL RIDGE DR
GASTONIA NC, 28056-9205, US
Phone (704) 674-5455
Fax
Business Location
2559 QUAIL RIDGE DR
GASTONIA NC, 28056-9205, US
Phone (704) 674-5455
Fax
Toxanomy
Taxonomy Code 251S00000X
License State
License Number
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According to our database, 612 Behavioral And Community Services NPI is 1336333129, taxonomy code is 251S00000X 612 Behavioral And Community Services physically located at 2559 Quail Ridge Dr, Gastonia NC, 28056-9205. NPI Number 1033115704 has the healthcare provider type.

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1336333129 NPI number is provided on an as is basis without warranty of any kind. 1336333129 is maintained by the National Plan & Provider Enumeration System. The contents of 612 Behavioral And Community Services are for informational purposes only.