# PAVANA TREATMENT GROUP, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043849896
- **Authorized official:** MELISSA BLOCKER (CFO)
- **Authorized official phone:** (864) 800-3223

## Contact information

- **Practice address:** 1560 UNION RD, GASTONIA, NC 28054-2209
- **Practice address phone:** (704) 490-4993
- **Mailing address:** 1560 UNION RD, GASTONIA, NC 28054-2209
- **Mailing address phone:** (704) 490-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | — | — | Yes |
| 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