Organization
GENTLEMEN'S QUARTERS I., LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY KATEAR ANDERSON B.S (EXECUTIVE DIRECTOR)
(704) 853-2665
Entity
Organization
Contact information
Practice address
801 S MAIN ST, APT. 91, MOUNT HOLLY, NC 28120-2048
(704) 820-9449
(704) 827-0718
Mailing address
105 STONERIDGE DR, MOUNT HOLLY, NC 28120-2041
(704) 853-2665
(704) 853-2665
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MHL-036-251
NC
251S00000X
Community/Behavioral Health Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-036-251
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/21/2007
Last updated
09/11/2025
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