# ADOLESCENT CARE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GATES COUNTY MEDICAL CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1083807325
- **Legal business name:** GATES COUNTY MEDICAL CENTER
- **Authorized official:** SYLIVA BOONE R.N. (OFFICE MANAGER)
- **Authorized official phone:** (252) 357-1226

## Contact information

- **Practice address:** 88 US HIGHWAY 158 W, GATESVILLE, NC 27938-9438
- **Practice address phone:** (252) 357-1244
- **Practice address fax:** (252) 357-1690
- **Mailing address:** 88 US HIGHWAY 158 W, GATESVILLE, NC 27938-9438
- **Mailing address phone:** (252) 357-1244
- **Mailing address fax:** (252) 357-1690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NC | Yes |

## Other

- **Enumeration date:** 08/21/2007
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8701702 | — | NC |