institution
Gaston Residential Services, Icf/mr, Inc.
Intellectual Disabilities Intermediate Care Facility in Gastonia, North Carolina
NPI 1891859203

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 Gastonia, NC. The NPI Number for Gaston Residential Services, Icf/mr, Inc. is 1891859203 and holds a License No. MHL-036-022 (North Carolina).

The current practice location address for Gaston Residential Services, Icf/mr, Inc. is 1101 E Franklin Blvd, Gastonia, NC and can be reached out via phone at 704-861-9280 and via fax at 704-868-2154. You can also correspond with Gaston Residential Services, Icf/mr, Inc. through the mailing address at 905A N NEW HOPE RD, GASTONIA, NC - 28054-3354 (mailing address contact number: 704-861-9280).

Location: 1101 E Franklin Blvd, Gastonia, NC, 28054-3354
institution
Provider Profile Details
NPI Number
1891859203
Provider Name
Gaston Residential Services, Icf/mr, Inc.
Credential
Provider Entity Type
Organization
Address
1101 E Franklin Blvd, Gastonia, NC, 28054-3354
Phone Number
704-861-9280
Fax Number
704-868-2154
Provider Enumeration Date
12/20/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3406373 05 NC
3406290 05 NC
3406472 05 NC
3406432 05 NC
3406554 05 NC
institution
Provider Business Practice Location Address Details
Address
1101 E Franklin Blvd
City
State
Zip
28054-4251
Phone Number
704-861-9280
Fax Number
704-868-2154
person
Provider Business Mailing Address Details
Address
1101 E Franklin Blvd
City
State
Zip
28054-4251
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
License No.
MHL-036-022 (North Carolina)
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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