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General NPI Number Information
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NPI Number | 1063235919
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Entity Type | Organization
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Legal Business Name | CARE 4 YOUTH FAMILY RESIDENTIAL SERVICES LLC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1616 NEAL HAWKINS RD
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City | GASTONIA
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State | NC
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Zip | 28056-6429
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Country | US
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Telephone | 704-685-8051
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Fax |
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Provider Business Mailing Address
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Address Line | 1072 JOSELYNN DR
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City | GASTONIA
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State | NC
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Zip | 28054-0035
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER-CEO
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Name | SHALIMAR ROSE
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Credential |
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Telephone | 704-685-8051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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