Organization
GREATER METROLINA MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON DAVIS (PRESIDENT)
(704) 865-5613
Entity
Organization
Contact information
Practice address
609 S NEW HOPE RD, SUITE 103, GASTONIA, NC 28054-4876
(704) 865-5613
Mailing address
PO BOX 219, GASTONIA, NC 28053-0219
(704) 865-5613
(704) 865-5614
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410160
—
NC
05
—
6005583
—
NC
05
—
8703161
—
NC
Enumeration date
01/05/2011
Last updated
01/26/2011
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