Organization
GAYLAIN'S HOUSE OF HOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN OLIVER LCAS (CEO)
(704) 491-0829
Entity
Organization
Contact information
Practice address
322 MCBEE STRRET, LINCOLNTON, NC 28092-2818
(047) 240-9453
(704) 360-2544
Mailing address
322 MCBEE ST, LINCOLNTON, NC 28092-2819
(704) 240-9453
(704) 240-9431
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
MHL-055-121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MHL-055-121
DHSR
NC
Enumeration date
03/10/2015
Last updated
07/20/2018
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