Individual
PENNEL ADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
613 POPLAR DR, SHELBY, NC 28152-7619
(980) 258-3094
Mailing address
3229 LIBERTY ELM LN, GASTONIA, NC 28056-5227
(802) 583-0949
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/27/2025
Last updated
07/07/2025
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