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General NPI Number Information
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NPI Number | 1417134354
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Entity Type | Organization
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Legal Business Name | GASTON SKILLS, INC
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 1636 SALEM CHURCH RD
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City | LINCOLNTON
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State | NC
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Zip | 28092-8909
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Country | US
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Telephone | 704-732-1516
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Fax | 704-732-0982
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Provider Business Mailing Address
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Address Line | 1301 BESSEMER CITY RD
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City | GASTONIA
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State | NC
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Zip | 28052-1106
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Country | US
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Telephone | 704-869-0300
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Fax | 704-869-9594
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DAVID FOGLE
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Credential |
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Telephone | 704-869-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | MHL-055-012
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License Number State | NC
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