Gaston Residential Services, Icf/Mr, Inc.

LBN: Gaston Residential Services, Icf/Mr, Inc.
Gaston Residential Services, Icf/Mr, Inc. is an health care organization with primary practice located at 1101 E Franklin Blvd , Gastonia NC 28054-4251. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Gaston Residential Services, Icf/Mr, Inc. can be contacted via phone (704) 861-9280, or through Weidert, Jaimee D via phone (704) 861-9280.

Contact Information

Primary practice address
1101 E Franklin Blvd Gastonia NC 28054-4251
Phone: (704) 861-9280
Fax: (704) 868-2154
Website:
Map and Directions
Authorized official contact:
Name: Weidert, Jaimee D
Phone: (704) 861-9280

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X MHL-036-022 North Carolina
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X MHL-036-069 North Carolina
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X MHL-036-016 North Carolina
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X MHL-036-011 North Carolina
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X MHL-036-046 North Carolina

Profile Details

NPI number 1891859203
LBN Legal business name Gaston Residential Services, Icf/Mr, Inc.
DBA Doing business as
Authorized official Weidert, Jaimee D
Entity Organization
Organization subpart 1 No
Enumeration date Dec 20th, 2006
Last updated Apr 8th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891859203 NPPES
North Carolina MEDICAID 3406373
North Carolina MEDICAID 3406290
North Carolina MEDICAID 3406472
North Carolina MEDICAID 3406432
North Carolina MEDICAID 3406554

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