Organization
CAROLINA COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY DAVIS (EXECUTIVE DIRECTOR)
(704) 853-8817
Entity
Organization
Contact information
Practice address
1556 D UNION RD, GASTONIA, NC 28054-2208
(704) 853-8817
Mailing address
PO BOX 1122, GASTONIA, NC 28053-1122
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
251S00000X
Community/Behavioral Health Agency
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301223
—
NC
Enumeration date
04/11/2007
Last updated
01/03/2008
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