Organization
GASTON LINCOLN CLEVELAND MHDDSA PROGRAM
Active
Other names
Pathways
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RHETT MELTON MBA (AREA DIRECTOR/CEO)
(704) 842-6328
Entity
Organization
Contact information
Practice address
901 S NEW HOPE RD, GASTONIA, NC 28054-5829
(704) 884-2501
(704) 854-4203
Mailing address
901 S NEW HOPE RD, GASTONIA, NC 28054-5829
(704) 884-2501
(704) 854-4203
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901923
—
NC
05
—
5901924
—
NC
05
—
5901925
—
NC
Enumeration date
03/21/2007
Last updated
11/23/2010
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