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Organization
IMPACT CAROLINA SERVICES INC
Active
Organization
IMPACT CAROLINA SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH O ADEDOKUN PH.D. (DIRECTOR)
(704) 732-2006
Entity
Organization
Contact information
Practice address
1006 UNION ROAD, SUITE B, GASTONIA, NC 28054-0000
(704) 864-8775
(980) 225-0549
Mailing address
1006 UNION ROAD, SUITE B, GASTONIA, NC 28054-0000
(704) 864-8775
(980) 225-0549
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NC
2084P0800X
Psychiatry Physician
—
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NC
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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