34D2159356 CLIA NUMBER - GASTONIA TREATMENT CENTER

Laboratory Demographics

CLIA Number: 34D2159356

Facility Name: GASTONIA TREATMENT CENTER

Facility Address:
238 WILMOT DRIVE
GASTONIA, NC
ZIP 28054
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Facility Phone Number: 980 285-2990

Facility Type: Other - OP OPIOID TREATMENT CNTR

Certificate Type: Waiver

NPI Number: 1053851410

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	34D2159356
LAB Type	Other - OP OPIOID TREATMENT CNTR
Facility Name	GASTONIA TREATMENT CENTER
Street	238 WILMOT DRIVE
City	GASTONIA
State	NC
ZIP	28054
Phone	980 285-2990
CertificateType	4
CertificateEffectiveDate	12/18/2022
CertificateExpirationDate	12/17/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024