Organization
MECCA OF BEACONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD RICHARDSON (OWNER)
(330) 559-0334
Entity
Organization
Contact information
Practice address
3016 FORBES RD, GASTONIA, NC 28056-6270
(330) 559-0334
Mailing address
908 ETTA PL, GASTONIA, NC 28054-4308
(330) 559-0334
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/22/2022
Last updated
06/22/2022
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