Southern Support

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

NPI 1982143848 · NPPES record last updated Feb 13, 2017

Key facts

NPI
1982143848
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
SOUTHERN SUPPORT
Practice address
480 River Rd
Gaston, NC 27832-9079
Phone
(252) 676-1750
NPI assigned
Feb 13, 2017
Organization subpart
No

Authorized official

Name
Mrs. Jacqueline Harris Dickens
Title
Owner
Phone
(252) 676-1750

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

480 River Rd
Gaston, NC 27832-9079

Mailing address

480 River Rd
Gaston, NC 27832-9079
Phone (252) 676-1750

Other providers in Gaston, NC

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

Sources for this page

Verify at the official NPI Registry.