OrganizationActive
Gaston Residential Services, Icf/Mr, Inc.
NPI 1316172125 · Intellectual Disabilities Intermediate Care Facility · Cherryville, NC
Provider details
- NPI number
- 1316172125
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Lynette Demperio, Finance Director(704) 861-9280
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1102 Requa Rd
Cherryville, NC 28021-9257
Phone: (704) 861-9280
Fax: (704) 868-2154
Street-level locationGet directions
Mailing address
905 N New Hope Rd Ste a
Gastonia, NC 28054-3373
Registry dates
- Enumerated
- 2009-05-22
- Last updated
- 2009-05-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.