Organization
PRO KIDS YOUTH AND FAMILY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMISE LAMAAR WILLIAMS (CEO)
(704) 674-5455
Entity
Organization
Contact information
Practice address
2559 QUAIL RIDGE DR, GASTONIA, NC 28056-9205
(704) 674-5455
(704) 867-7338
Mailing address
2559 QUAIL RIDGE DR, GASTONIA, NC 28056-9205
(704) 674-5455
(704) 867-7338
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320800000X
NC
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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