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Organization
PAVANA TREATMENT GROUP, P.C.
Active
Organization
PAVANA TREATMENT GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA BLOCKER (CFO)
(864) 800-3223
Entity
Organization
Contact information
Practice address
1560 UNION RD, GASTONIA, NC 28054-2209
(704) 490-4993
Mailing address
1560 UNION RD, GASTONIA, NC 28054-2209
(704) 490-4993
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
—
NULL
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
04/03/2020
Last updated
08/13/2024
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