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General NPI Number Information
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NPI Number | 1235239567
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Entity Type | Organization
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Legal Business Name | CENTURY CARE OF GASTONIA, INC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 2780 X RAY DR
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City | GASTONIA
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State | NC
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Zip | 28054-7490
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Country | US
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Telephone | 704-861-0981
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Fax | 704-861-0388
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Provider Business Mailing Address
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Address Line | 2780 X RAY DR
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City | GASTONIA
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State | NC
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Zip | 28054-7490
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Country | US
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Telephone | 704-861-0981
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Fax | 704-861-0388
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Authorized Official
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Title or Position | CFO / SECRETARY
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Name | MR. BRIAN S HILL
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Credential |
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Telephone | 919-290-2722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH0402
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License Number State | NC
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