Organization
EAGLES NEST OF GASTONIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN GAVIN (OWNER)
(980) 522-7724
Entity
Organization
Contact information
Practice address
3908 S NEW HOPE RD, GASTONIA, NC 28056-8450
(980) 522-7724
Mailing address
PO BOX 163, GASTONIA, NC 28053-0163
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
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