Gaston Adolescent Center, Inc.

NPI 1093949109 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1093949109
Enumeration Date 05/05/2009
Last Updated 09/28/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name EDWARD LAWRENCE EDWARD
Position CEO
Phone (704) 691-7561
Fax (704) 691-7563
Practice Location
635 COX RD
SUITE B
GASTONIA NC, 28054-3441, US
Phone (704) 691-7561
Fax (704) 691-7563
Business Location
635 COX RD STE B
GASTONIA NC, 28054-3441, US
Phone (704) 691-7561
Fax (704) 691-7563
Toxanomy
Taxonomy Code 251S00000X
License State North Carolina
License Number MHL-036-274
Remove 1093949109 NPI Number
 

According to our database, Gaston Adolescent Center, Inc. NPI is 1093949109, taxonomy code is 251S00000X and license number is MHL-036-274, license state is located at North Carolina. Gaston Adolescent Center, Inc. physically located at 635 Cox Rd, Gastonia NC, 28054-3441. NPI Number 1033115704 has the healthcare provider type.

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1093949109 NPI number is provided on an as is basis without warranty of any kind. 1093949109 is maintained by the National Plan & Provider Enumeration System. The contents of Gaston Adolescent Center, Inc. are for informational purposes only.