Organization · Type 2 NPI

Lutheran Family Services In the Carolinas

Intellectual Disabilities Intermediate Care Facility · Gastonia, NC

NPI number 1851447221 Active

Practice location

810 King Arthur Dr
Gastonia, NC 28056-8469

Call (704) 824-8941 Map

Mailing address

PO Box 2369
Salisbury, NC 28145-2369

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency	251S00000X	None listed
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	MHL036031 (NC)
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	MHL-036-031 (NC)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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NPI record

NPI: 1851447221
Entity type: Organization (Type 2)
Issued: Jan 26, 2007
Last updated: Jun 26, 2017
Status: Active
Subpart: Yes of Lutheran Family Services In the Carolinas

Other names

<unavail>
Mountain Ridge Group Home · doing business as

Authorized official

Mr. Kirby Nickerson
Chief Financial Officer
(704) 754-8228

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1851447221

Lutheran Family Services In the Carolinas's National Provider Identifier is 1851447221, issued on Jan 26, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Gastonia, NC. The record was last updated on Jun 26, 2017.