Organization
GTOG SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACEY N GAINEY II (PRESIDENT)
(336) 624-4183
Entity
Organization
Contact information
Practice address
218 MARTIN LUTHER KING AVE, KINGSTREE, SC 29556-4072
(980) 585-4843
Mailing address
5009 -D ENDOLWOOD ST., CHARLOTTE, NC 28215
(980) 585-4843
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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