Organization
LUMINA ONE LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY D DAVIS (OWNER)
(413) 297-1660
Entity
Organization
Contact information
Practice address
106 W THIRD AVE, GASTONIA, NC 28052-4321
(413) 297-1660
Mailing address
100 W MAIN AVE APT 407, GASTONIA, NC 28052-4172
(413) 297-1660
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
03/24/2026
Last updated
04/13/2026
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