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Gaynelle Bolling
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Pikeville, North Carolina
NPI 1649895442

Gaynelle Bolling is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Pikeville, NC. Gaynelle Bolling practices in Pikeville, NC. The NPI Number for Gaynelle Bolling is 1649895442 and holds a License No. (North Carolina).

The current practice location address for Gaynelle Bolling is 102 Mandarin Dr, Pikeville, NC and can be reached out via phone at 919-214-1911.

Location: 102 Mandarin Dr, Pikeville, NC, 27863-0020
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649895442
Provider Name
Gaynelle Bolling
Credential
Provider Entity Type
Individual
Gender
Female
Address
102 Mandarin Dr, Pikeville, NC, 27863-0020
Phone Number
919-214-1911
Fax Number
Provider Enumeration Date
06/08/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
85-1342554 01 INTERNAL REVENUE SERVICE
institution
Provider Business Practice Location Address Details
Address
102 Mandarin Dr
City
Pikeville
State
North Carolina
Zip
27863-0020
Phone Number
919-214-1911
Fax Number
person
Provider Business Mailing Address Details
Address
102 Mandarin Dr
City
Pikeville
State
North Carolina
Zip
27863-0020
Phone Number
919-214-1911
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
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Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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