Organization
GASTONIA CORNERSTONE CHRISTIAN CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID L. FOGLE (EXECUTIVE DIRECTOR)
(704) 867-8749
Entity
Organization
Contact information
Practice address
400 E 5TH AVE, GASTONIA, NC 28054-0441
(704) 867-8749
(704) 869-8892
Mailing address
PO BOX 2074, GASTONIA, NC 28053-2074
(704) 867-8749
(704) 869-8892
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6106324
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301639B
—
NC
Enumeration date
04/06/2009
Last updated
06/12/2009
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