Odyssey Behavioral Health Care LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

ODYSSEY BEHAVIORAL HEALTH CARE LLC

Practice address

4912 Duncan LN
Gastonia, NC 28056-9361

Phone

(704) 941-7938

NPI assigned

Dec 13, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pamler Rebecca Walls Ervin

Title

Owner

Phone

(704) 941-7938

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1225845175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39024",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282781050",
            "telephone_number": "704-941-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 DUNCAN LN",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280569361",
            "telephone_number": "704-941-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY BEHAVIORAL HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "WALLS ERVIN",
        "authorized_official_first_name": "PAMLER",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-941-7938"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitriona O'Shaughnessy, PT/PEDS
• Carla C Oakes, PT
• Oasis Therapeutic Services PLLC
• Shirley D Ocloo, M.D.
• Lamika R Odums
• Odyssey Home Healthcare
• Julia H Oesterle, MSW, LCSW
• Office Gems Business Agency
• Deborah Ogden, RN
• Chang Kyeong Oh, M.D.

• All providers in Gastonia, NC
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.