612 Behavioral and Community Services

Organization Active NPI Community/Behavioral Health Agency · Gastonia, NC

NPI 1336333129 · NPPES record last updated Sep 5, 2007

Key facts

NPI
1336333129
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
612 BEHAVIORAL AND COMMUNITY SERVICES
Practice address
2559 Quail Ridge Dr
Gastonia, NC 28056-9205
Phone
(704) 674-5455
NPI assigned
Sep 5, 2007
Organization subpart
No

Authorized official

Name
Demise Lamaar Williams
Title
Ceo
Phone
(704) 674-5455

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

2559 Quail Ridge Dr
Gastonia, NC 28056-9205

Mailing address

2559 Quail Ridge Dr
Gastonia, NC 28056-9205
Phone (704) 674-5455

Other providers in Gastonia, NC

All providers in Gastonia, NC · Community/Behavioral Health Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.