| Gastonia Cornerstone Christian Center Inc. | |
|
400 E 5th Ave Gastonia NC 28054-0441 | |
| (704) 867-8749 | |
| (704) 869-8892 |
| Full Name | Gastonia Cornerstone Christian Center Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 400 E 5th Ave, Gastonia, North Carolina |
| Authorized Official Name and Position | David L. Fogle (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7048678749 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastonia Cornerstone Christian Center Inc. Po Box 2074 Gastonia NC 28053-2074 Ph: (704) 867-8749 | Gastonia Cornerstone Christian Center Inc. 400 E 5th Ave Gastonia NC 28054-0441 Ph: (704) 867-8749 |
| NPI Number | 1053553008 |
|---|---|
| Provider Enumeration Date | 04/06/2009 |
| Last Update Date | 06/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053553008 | NPI | - | NPPES |
| 8301639B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6106324 (North Carolina) | Primary |
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