OrganizationActive
Gaston Residential Services, Icf/Mr, Inc.
NPI 1891859203 · Intellectual Disabilities Intermediate Care Facility · Gastonia, NC
Provider details
- NPI number
- 1891859203
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Jaimee Weidert, Finance Director(704) 861-9280
- License
- MHL-036-016 (NC)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Practice location
1101 E Franklin Blvd
Gastonia, NC 28054-4251
Phone: (704) 861-9280
Fax: (704) 868-2154
Approximate (ZIP-level) locationGet directions
Mailing address
905a N New Hope Rd
Gastonia, NC 28054-3354
Registry dates
- Enumerated
- 2006-12-20
- Last updated
- 2019-04-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.