Organization
FOOTPRINTS CAROLINA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM STRICKLAND DAVIS (QAQI MANAGER)
(704) 524-2009
Entity
Organization
Contact information
Practice address
970 ROBERTS DR, GASTONIA, NC 28054-5804
(704) 854-4826
(704) 524-2095
Mailing address
2020 REMOUNT RD, GASTONIA, NC 28054-7437
(704) 524-2009
(704) 524-2095
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
08/22/2020
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