Organization
ODYSSEY BEHAVIORAL HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMLER REBECCA WALLS ERVIN (OWNER)
(704) 941-7938
Entity
Organization
Contact information
Practice address
4912 DUNCAN LN, GASTONIA, NC 28056-9361
(704) 941-7938
Mailing address
PO BOX 39024, CHARLOTTE, NC 28278-1050
(704) 941-7938
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/13/2024
Last updated
12/18/2024
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