Healthcare Provider Details

I. General information

NPI: 1831273440
Provider Name (Legal Business Name): THE WORKSHOP OF DAVIDSON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 MONROE RD
LEXINGTON NC
27292-9707
US

IV. Provider business mailing address

PO BOX 906
LEXINGTON NC
27293-0906
US

V. Phone/Fax

Practice location:
  • Phone: 336-248-2816
  • Fax: 336-248-4995
Mailing address:
  • Phone: 336-248-2816
  • Fax: 336-248-4995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL-029-024
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL-029-025
License Number StateNC

VIII. Authorized Official

Name: MR. CARROL DELANE GANTT
Title or Position: ADMINISTRATOR
Credential:
Phone: 336-248-2816