Healthcare Provider Details

I. General information

NPI: 1700223310
Provider Name (Legal Business Name): G & S FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 CRISMAN ST STE 102
CHARLOTTE NC
28208-3847
US

IV. Provider business mailing address

2801 CRISMAN ST STE 102
CHARLOTTE NC
28208-3847
US

V. Phone/Fax

Practice location:
  • Phone: 704-657-4423
  • Fax:
Mailing address:
  • Phone: 704-657-4423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: COREY SUTTON
Title or Position: CO-DIRECTOR
Credential:
Phone: 704-657-4423