Organization
GASTON RESIDENTIAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNETTE GRASLIE DEMPERIO (FINANCE DIRECTOR/VICE PRESIDENT)
(704) 861-9280
Entity
Organization
Contact information
Practice address
905 N NEW HOPE RD STE A, GASTONIA, NC 28054-3373
(704) 861-9280
(704) 868-2154
Mailing address
905 N NEW HOPE RD STE A, GASTONIA, NC 28054-3373
(704) 861-9280
(704) 868-2154
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-036-023
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MHL-036-023
STATE OF NORTH CAROLINA
NC
Enumeration date
10/05/2007
Last updated
10/05/2007
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