Organization
FRIDAY'S PLACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH L FRIDAY QMHP (EXECUTIVE DIRECTOR)
(704) 864-0366
Entity
Organization
Contact information
Practice address
811 S OAKLAND ST STE A, GASTONIA, NC 28054-0472
(704) 864-0366
(704) 864-0311
Mailing address
PO BOX 2212, GASTONIA, NC 28053-2212
(704) 864-0366
(704) 864-0311
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6005964
NC
2084P0804X
Child & Adolescent Psychiatry Physician
5909113
NC
251B00000X
Case Management Agency
8300372
NC
251C00000X
Developmentally Disabled Services Day Training Agency
3408063
NC
251S00000X
Community/Behavioral Health Agency
Primary
8300372
NC
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
3408063
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408063
—
NC
05
—
5909113
—
NC
05
—
6005964
—
NC
05
—
8300372
—
NC
05
—
8300372B
—
NC
05
—
8300372G
—
NC
05
—
8300372H
—
NC
Enumeration date
11/22/2006
Last updated
08/04/2008
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