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Organization
ONE LOVE DEVELOPMENTAL SERVICES, INC
Active
Organization
ONE LOVE DEVELOPMENTAL SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVIE WIDEMAN (VICE PRESIDENT)
(704) 642-0140
Entity
Organization
Contact information
Practice address
324 W MAIN AVE, GASTONIA, NC 28052-4113
(704) 642-0140
Mailing address
PO BOX 2223, SALISBURY, NC 28145-2223
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408216
—
NC
05
—
6603307
—
NC
05
—
6603555
—
NC
05
—
6603717
—
NC
05
—
6603804
—
NC
05
—
8300947
—
NC
Enumeration date
11/28/2006
Last updated
09/10/2010
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