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Gaston Residential Services, Icf/mr, Inc.
Intellectual Disabilities Intermediate Care Facility in Cherryville, North Carolina
NPI 1316172125

Gaston Residential Services, Icf/mr, Inc. is a Intellectual Disabilities Intermediate Care Facility based in Gastonia, NC. Gaston Residential Services, Icf/mr, Inc. practices in Cherryville, NC. The NPI Number for Gaston Residential Services, Icf/mr, Inc. is 1316172125 and holds a License No. (North Carolina).

The current practice location address for Gaston Residential Services, Icf/mr, Inc. is 1102 Requa Rd, Cherryville, NC and can be reached out via phone at 704-861-9280 and via fax at 704-868-2154.

Location: 1102 Requa Rd, Cherryville, NC, 28054-3373
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316172125
Provider Name
Gaston Residential Services, Icf/mr, Inc.
Credential
Provider Entity Type
Organization
Address
1102 Requa Rd, Cherryville, NC, 28054-3373
Phone Number
704-861-9280
Fax Number
704-868-2154
Provider Enumeration Date
05/22/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3406432 05 NC
institution
Provider Business Practice Location Address Details
Address
1102 Requa Rd
City
Cherryville
State
North Carolina
Zip
28021-9257
Phone Number
704-861-9280
Fax Number
704-868-2154
person
Provider Business Mailing Address Details
Address
1102 Requa Rd
City
Cherryville
State
North Carolina
Zip
28021-9257
Phone Number
704-861-9280
Fax Number
704-868-2154
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
()
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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