Organization
PIEDMONT PIONEER HOUSE, INC.
Active
Organization
PIEDMONT PIONEER HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VONDA KAYE BURTON QMHP, QDDP (EXECUTIVE DIRECTOR)
(704) 884-2701
Entity
Organization
Contact information
Practice address
910 ROBERTS DR, GASTONIA, NC 28054-5804
(704) 866-8751
Mailing address
910 ROBERTS DR, GASTONIA, NC 28054-5804
(704) 866-8751
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-036-004
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301292S
—
NC
Enumeration date
06/12/2007
Last updated
08/22/2020
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