Organization
GASTON FAMILY HEALTH SERVICES, INC.
Active
Organization
GASTON FAMILY HEALTH SERVICES, INC.
Active
Parent organization
GASTON FAMILY HEALTH SERVICES, INC
Other names
Kintegra/SHA at Ashley Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
GASTON FAMILY HEALTH SERVICES, INC
Authorized official
MRS. SHARMILA ANDERSON (BUSINESS SERVICES ADMINISTRATOR)
(704) 874-1907
Entity
Organization
Contact information
Practice address
1647 NE ASHLEY SCHOOL CIRCLE, WINSTON-SALEM, NC 27105-5444
(336) 703-4205
(336) 245-4592
Mailing address
200 E 2ND AVE, GASTONIA, NC 28052-4358
(704) 874-1904
(704) 874-0707
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005802
—
NC
Enumeration date
08/18/2008
Last updated
10/01/2020
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