612 BEHAVIORAL AND COMMUNITY SERVICES NPI 1336333129

NPI Information

  • NPI: 1336333129
  • Provider Name: 612 BEHAVIORAL AND COMMUNITY SERVICES
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Address: 2559 QUAIL RIDGE DR
    GASTONIA, NC
    ZIP 28056
  • Phone: (704) 674-5455

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NPI Details

612 BEHAVIORAL AND COMMUNITY SERVICES is a community behavioral health in Gastonia, NC. The provider is 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. 612 BEHAVIORAL AND COMMUNITY SERVICES NPI is 1336333129. The provider is registered as an organization entity type.

The provider's business location address is:

2559 QUAIL RIDGE DR
GASTONIA, NC
ZIP 28056-205
Phone: (704) 674-5455

The provider's authorized official is Demise Lamaar Williams .
The authorized official title is Ceo and has the following contact phone number (704) 674-5455.

The enumeration date for this NPI number is 9/5/2007 and was last updated on 9/5/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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